Epidemiol Health.  2015;37:e2015044. 10.4178/epih/e2015044.

Risk factors for amputation in patients with diabetic foot ulcer in southwest Iran: a matched case-control study

• Kogani M
• Mansournia MA
• Doosti-Irani A
• Holakouie-Naieni K

• KMID: 2380681
• DOI: http://doi.org/10.4178/epih/e2015044

Abstract

OBJECTIVES
Amputation is a multifactorial complication in diabetic patients. The aim of this study was to determine the risk factors associated with amputation in patients with diabetic foot ulcers.
METHODS
This matched case-control study was conducted based on new cases of amputation from March 2012 to November 2014. We selected new cases who had undergone amputation, and the control group was chosen from the cities or areas where the cases resided. Each case was matched with two controls based on the duration of diabetes and location. Conditional logistic regression was used to evaluate the associations between potential risk factors and amputation.
RESULTS
A total of 131 cases were compared with 262 controls. The results of the adjusted model showed that sex (odds ratio [OR], 8.66; 95% confidence interval [CI], 2.68 to 27.91), fewer than two hemoglobin A1c (HbA1c) tests per year (OR, 13.97; 95% CI, 4.97 to 39.26), unsuitable shoes (OR, 5.50; 95% CI, 2.20 to 13.77), smoking (OR, 3.44; 95% CI, 1.45 to 8.13), and body mass index (OR, 1.20; 95% CI, 1.03 to 1.41) were associated with amputation in diabetic patients.
CONCLUSIONS
The most important factors associated with amputation were females, irregular monitoring of HbA1c levels, improper footwear, and smoking. Developing educational programs and working to ensure a higher quality of care for diabetic patients are necessary steps to address these issues.

Keyword

Amputation; Risk factors; Case-control studies; Diabetes mellitus; Iran

MeSH Terms

Amputation*
Body Mass Index
Case-Control Studies*
Diabetes Mellitus
Diabetic Foot*
Female
Humans
Iran*
Logistic Models
Risk Factors*
Shoes
Smoke
Smoking
Ulcer*
Smoke