J Korean Foot Ankle Soc.  2016 Sep;20(3):121-125. 10.14193/jkfas.2016.20.3.121.

The Amputation Rate and Associated Risk Factors within 1 Year after the Diagnosis of Diabetic Foot Ulcer

• Chun DI
• Jeon MC
• Choi SW
• Kim YB
• Nho JH
• Won SH

• KMID: 2351417
• DOI: http://doi.org/10.14193/jkfas.2016.20.3.121

Abstract

PURPOSE
This study investigates the amputation rate within 1 year after the diagnosis of diabetic foot ulcer and its associated risk factors.
MATERIALS AND METHODS
This study enrolled 60 patients with diabetic foot ulcer. The mean and standard deviation age was 64.4±12.8 years (range, 32~89 years); the mean and standard deviation prevalence period for diabetes mellitus was 21.0±7.5 years (range, 0.5~36 years). The amputation rate was evaluated by dividing the subjects into two groups"”the major and minor amputation groups"”within 1 year following the initial diagnosis of diabetic foot ulcer. Multivariate Cox proportional hazards regression analysis was used to identify the risk factors for amputation.
RESULTS
The total amputation rate of 38.3% (n=23) was comprised of the amputation rate for the major amputation group (10.0%) and rate for the minor amputation group (23.8%). There was a high correlation between peripheral artery disease (toe brachial pressure index <0.7) and amputation (hazard ratio [HR] 5.81, confidence interval [CI] 2.09~16.1, p<0.01). Nephropathy was significantly correlated with the amputation rate (HR 3.53, CI 1.29~9.64, p=0.01).
CONCLUSION
Clinicians who treat patients with diabetic foot complications must understand the fact that the amputation rate within 1 year is significant, and that the amputation rate of patients with peripheral artery disease or nephropathy is especially high.

Keyword

Diabetic foot ulcer; Amputation rate; Risk factor

MeSH Terms

Amputation*
Diabetes Mellitus
Diabetic Foot*
Diagnosis*
Humans
Peripheral Arterial Disease
Prevalence
Risk Factors*
Ulcer*

Figure

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  Fig. 1. Kaplan-Meier curves depending on toe-brachial pressure index (log-rank test p<0.01). TBPI: toe-brachial pressure index.

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  Fig. 2. Kaplan-Meier curves depending on nephropathy (log-rank test p<0.01).

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