J Korean Foot Ankle Soc.  2012 Dec;16(4):257-264.

Comprehensive Analysis for Risk Factors of Lower Extremity Amputation as a Treatment of Complicated Diabetic Foot

• Chung HJ
• Bae SY
• Min BK
• Park JG
• Kam MC
• Choi JW

Abstract

PURPOSE
The diabetic foot lesions are intractable, and aggravation often leads to amputation. None or minor amputation group was treated debridement or toe amputation and major amputation group was treated Ray, Lisfranc, Chopart, Below Knee and Above Knee amputation. We investigate the risk factors for major limb amputations among patients with diabetic foot lesion.
MATERIALS AND METHODS
The subjects were 73 diabetic foot lesion patients (83 diabetic foot lesions) treated at our department from January 2006 to December 2010. Non or Minor amputation group of 44 cases were treated with debridement or toe amputation. Major amputation group of 39 cases were treated with Ray, Lisfranc, Chopart, below or above Knee amputation. We investigated socioeconomic factors, diabetes mellitus related factors and wound related factors and laboratory factors. Statistical analysis was done by Students t-test, Chi-square test, Mann-Whitney's U test.
RESULTS
In our analysis, wound size, wound classification (Wagner classification, Brodsky classification), white blood cell counts, polymorphoneuclear neutrophil percentage, hemoglobin, C-reactive protein and albumin were risk factors for major amputation (p<0.05).
CONCLUSION
Low education level, nutritional condition, premorbid activity level and progressed wound condition were observed in major amputation group compared with non or minor amputation group. In the major amputation group, higher white blood cell count, C-reactive protein level and lower albumin level were observed. Together with maintenance of adequate nutritional condition, early detection of lesions and foot care for early treatment is important. Therefore, active investigation with full risk evaluation of vascular complication is also important.

Keyword

Diabetic foot; Risk factors; Amputation

MeSH Terms

Amputation
C-Reactive Protein
Debridement
Diabetes Mellitus
Diabetic Foot
Extremities
Foot
Hemoglobins
Humans
Knee
Leukocyte Count
Lower Extremity
Neutrophils
Risk Factors
Socioeconomic Factors
Toes
C-Reactive Protein
Hemoglobins