Evaluation of major and minor lower extremity amputation in diabetic foot patients

Ozan, Fırat; Gürbüz, Kaan; Çelik, İ̇lhami; Dursun, Zehra Beştepe; Uzun, Erdal

doi:10.3906/sag-1601-58

Cited by 22 publications

(28 citation statements)

References 23 publications

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“…We found that age was not a significant risk factor for amputation in patients with DFI. However, male sex and smoking, which were indicated as risk factors for amputation in diabetes‐related foot ulceration, were also found to be risk factors for amputation in DFI in our meta‐analysis. This may be because male sex and smoking have traditionally been the main factors in the development of PAD caused by atherosclerotic plaque formation.…”

Section: Discussionmentioning

confidence: 61%

“…Foot complications are common among elderly patients with diabetes . We found that age was not a significant risk factor for amputation in patients with DFI.…”

Section: Discussionmentioning

confidence: 67%

“…Foot complications are common among elderly patients with diabetes. 35 We found that age was not a significant risk factor for amputation in patients with DFI. However, male sex and smoking, which were indicated as risk factors for amputation in diabetes-related foot ulceration, 12,35 were also found to be risk factors for amputation in DFI in our meta-analysis.…”

Section: Meta-analysis Of the Clinical Findingsmentioning

confidence: 60%

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Meta‐analysis of risk factors for amputation in diabetic foot infections

Şen

Demırdal

Emir

2019

Diabetes Metabolism Res

134

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Background Knowledge of risk factors is crucial to develop management and treatment protocols for the prevention of lower extremity amputation for patients with diabetic foot infections (DFIs). Methods We searched the research literature for studies reporting risk factors for lower extremity amputation in patients with DFI. The main outcome variables included both minor and major amputations. This study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42018118543). Results A total of 2471 potential articles from the database search met the inclusion criteria. After reviewing the titles, abstracts, and full texts, remaining 25 articles were included in the final analysis. We identified 6132 patients with DFI in the 25 included articles. Of these, 1873 patients who underwent amputation were investigated. Male gender (odds ratio [OR]: 1.31), smoking (OR: 1.38), history of amputation (OR: 1.47), history of osteomyelitis (OR: 1.94), peripheral arterial disease (OR: 2.35), retinopathy (OR: 1.32), International Working Group on the Diabetic Foot (IWGDF) grades 3 and 4 (OR: 1.7 and 2.5), Wagner grades 4 and 5 (OR: 4.3 and 6.4), gangrene/necrosis (OR: 9.9), osteomyelitis (OR: 4.5), neuroischaemic DFI (OR: 3.06), severe infection (OR: 3.12), length of hospitalization (standardized mean difference [SMD]: 0.7), leukocytosis (OR: 1.76), mean erythrocyte sedimentation rate (ESR) (SMD: 0.5), mean C‐reactive protein (CRP) (SMD: 0.8), tissue culture positivity (OR: 1.61), and isolation of Gram‐negative bacteria from tissue culture (OR: 1.5) were found as predictors of amputation in DFI. Conclusions The present study highlighted some differences in diabetic foot ulcers and DFIs in terms of risk factors for lower extremity amputation. These data provide detailed information about risk factors for amputations among patients with DFI, thus contributing to the creation of new classification systems for assessment of high‐risk patients.

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Section: Discussionmentioning

confidence: 61%

“…Foot complications are common among elderly patients with diabetes . We found that age was not a significant risk factor for amputation in patients with DFI.…”

Section: Discussionmentioning

confidence: 67%

Section: Meta-analysis Of the Clinical Findingsmentioning

confidence: 60%

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Meta‐analysis of risk factors for amputation in diabetic foot infections

Şen

Demırdal

Emir

2019

Diabetes Metabolism Res

134

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“…Diabetic foot ulcer (DFU) leading to lower extremity amputation (LEA) is one of the common complications of diabetes mellitus (DM) . DFUs are complex, chronic wounds, which have a major long‐term impact on the morbidity, mortality, physical distress, as well as financial losses that lower the quality of subjects' lives .…”

Section: Introductionmentioning

confidence: 99%

Impact of multidisciplinary foot care team on outcome of diabetic foot ulcer in term of lower extremity amputation at a tertiary care unit in Karachi, Pakistan

Riaz

Miyan

Waris

et al. 2019

International Wound Journal

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To compare the outcomes of diabetic foot ulcers (DFU) in terms of healing and lower extremity amputation (LEA) rate before and after training of multidisciplinary foot care team (MDFCT). Subjects were categorised into two groups; Group‐A cases seen between 1997 and 2006 (before upgrading of training and services of MDFCT) and Group‐B cases seen between 2007 and 2016 (after upgrading of training and services of MDFCT). Baseline demographic characteristics, biochemical results, and outcomes of DFU in terms of healing or amputation were analysed by using statistical package social science (SPSS) version 20. Total 7994 DFU cases seen, 888 in group A and 7106 in group B. Mean age of patients was 53.80 ± 10.40 years and mean haemoglobin (HbA1c) was 10.12 ± 2.44. Overall, decreasing trends of amputations were observed from baseline 27.5% to 3.92% during the period of 20 years. In group A, 479 (78.8%) subjects healed completely compared with 3806 (89.1%) in group B. Significant reduction in toe amputations ([13.81%] vs [8.11%]) and below knee amputations [(5.26%) vs (1.82%)] were seen. Similarly, rates of above knee amputation ([1.80%] vs [0.35%] P‐value 0.008) in two groups was also significant. Significant improvement was observed in outcomes of DFU in terms of amputation through multidisciplinary team approach.

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“…DM is a known systemic disease associated with increased incidence of morbidity and mortality. The treatment period of ulcers is long and poor treatment can lead to extremity amputations (3). Because of the amputation and mortality rate, diabetic foot receives more attention as a severe complication related to DM.…”

Section: Introductionmentioning

confidence: 99%

Hand infection in patients with diabetes: a series of 17 cases and a pooled analysis of the literature

2018

Turk J Med Sci

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The aim of this study was to report the clinical characteristics and the treatment outcomes of hand infections in diabetic patients and to review the literature. Materials and methods:The medical records of 17 patients with diabetic hand infections admitted to the Diabetic Foot Care Center of two different clinics from January 2012 to October 2017 were reviewed. To perform the pooled analysis, published series (32 studies) were searched in two international databases (www.scopus.com and www.pubmed.com).Results: Of the 17 patients (mean age 61.7 ± 8.5 years), 8 (47.1%) were female. All cases were type 2 diabetes mellitus. The mean duration of diabetes was 9.0 ± 5.96 years and the mean HbA1c was 7.86 ± 1.88%. There was necrosis in 8 patients (47.1%). The most common causes were injury during saw and hammer use in 5 patients (29.4%) and injury due to inappropriate nail cutting in 3 patients (17.6 %). Nine (52.9%) patients were operated on. No patients underwent any major amputations or died. In 32 publications, 704 patients with diabetic hand infections were found. The average age was 53.43 years (n = 591) and 84.29% of patients (322/382) were found to have type 2 DM. The mean duration of diabetes was 4.12 years (n = 317) and the mean HbA1c was 10.58% (n = 140). The rate of surgical operation was 74.59% (323/433). Conclusion:Diabetic hand injuries often occur when using hand tools such as hammers, saws, and knives, and when cutting nails. It is necessary to use conservative treatment rather than amputation. These patients should consult experienced health care professionals.

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Evaluation of major and minor lower extremity amputation in diabetic foot patients

Cited by 22 publications

References 23 publications

Meta‐analysis of risk factors for amputation in diabetic foot infections

Meta‐analysis of risk factors for amputation in diabetic foot infections

Impact of multidisciplinary foot care team on outcome of diabetic foot ulcer in term of lower extremity amputation at a tertiary care unit in Karachi, Pakistan

Hand infection in patients with diabetes: a series of 17 cases and a pooled analysis of the literature

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