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

Kogani, Mohammad; Mansournia, Mohammad Alì; Doosti-Irani, Amin

doi:10.4178/epih/e2015044

Cited by 27 publications

(30 citation statements)

References 14 publications

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“…The females were found to be at an 8.66 times higher risk of amputation than males. 22 This result is consistent with the findings of another study but is inconsistent with the results of Mashaekhi et al and the findings from our study. 23,24 The prolonged hospital stay of more than 14 days was noted in only 1 (8.33%) patient with HbA1C (7 to 7.9%), 10 (38.46%) patients with HbA1C (8 to 8.9%) and 24 (58.54%) patients with HbA1C > 9%.…”

Section: Resultscontrasting

confidence: 53%

The importance of HbA1C and erythrocyte sedimentation rate as prognostic factors in predicting the outcome of diabetic foot ulcer disease

2017

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Background:The study is to determine the relation between the high HbA1c and ESR as prognostic factors with the severity of the diabetic foot ulcer disease, particularly, in predicting the final outcome in the form of higher incidence of lower extremity amputation (LEA) and/or prolonged hospital stay. The study explored the importance of increased level of serum HbA1c and erythrocyte sedimentation rate (ESR) in determining the final outcome of the disease. It revealed that the severity of diabetic foot ulcer disease is more in patients who had concomitant high levels of baseline HbA1c and ESR on admission. Methods: This observational study was done in 89 patients who were admitted in the surgical wards of the two teaching hospitals in India. The cohort consisted of patients from the age of 26 to 83 years of age who presented with clinically infected foot ulcers. Routine blood tests were done which include HbA1C on the day of admission and fasting ESR (1st hour) on the next day morning. The standard X-ray plates were routinely taken on the first day for determination of the involvement of underlying bones and soft tissues. The outcome of the diabetic foot ulcer was assessed from the severity of the disease according to Meggit-Wagner classification, the incidence of lower extremity amputation and the duration of hospital stay. Results: The high levels of baseline HbA1C (more than 7.0%) in blood on the first day of admission was found in all of the 89 patients who were included in this study but the criteria for consideration of high risk was more than 9% which was found in 41 patients. The criteria for consideration of high ESR in this study was set to be 50 mm/h. High ESR of more than 50 mm was found in 63 patients. We had subdivided 31 patients into a High Risk Group whose baseline levels of HbA1C > 9% and ESR > 50 mm/h. The incidence of amputation was 79.31% and 44.44% with HbA1c of more than 9.0% and ESR of more than 50 mm respectively and was considerably increased (83.87%) when both HbA1c and ESR were more than the critical value as set in the study. Similarly, the incidence of prolonged hospital stay of more than 14 days was 58.54% in patients with HbA1C level of greater than 9 %, 51.85% in patients with baseline ESR > 50 mm/h and 93.55% in presence of high levels of both HbA1C (>9%) and ESR (>50 mm/h).. Conclusions: The study observed that the patients who presented with baseline high levels of HbA1C, ESR or both on admission had unfavourable prognosis with increased incidence of lower extremity amputation and prolonged hospital stay than the other patients in the cohort. .

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Section: Resultscontrasting

confidence: 53%

The importance of HbA1C and erythrocyte sedimentation rate as prognostic factors in predicting the outcome of diabetic foot ulcer disease

2017

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“…Because patients with type 1 diabetic mellitus have absolute insulin deficiency, even missing treatment on one occasionwill result in hyperglycemia and other hyperglycemia-related complications. 19,20 Limitation of the Study…”

Section: Discussionmentioning

confidence: 99%

<p>Determinants of Diabetic Complication Among Adult Diabetic Patients in Debre Markos Referral Hospital, Northwest Ethiopia, 2018: Unmatched Case Control Study</p>

Kidanie

Alem

Zeleke

et al. 2020

DMSO

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Background: Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia, and are caused by a complex interaction of genetics and environmental factors. Diabetes mellitus produces change in the blood vessels and therefore affects almost every part of the body. Methods: A hospital-based unmatched case control study was conducted from February 2018 to April 2018 at Debre Markos Referral Hospital. Data were collected from 204 individuals, 136 controls and 68 cases using an interviewer-administered questionnaire and patient chart. Data were entered into EPI-data 3.1 software and exported to SPSS version 21 for analysis. Descriptive analysis including mean, median and proportions was carried out. In bivariate analysis, variables below 0.25 significance level were selected for multivariable analysis. For multivariable analysis, a backward model was selected and 95% confidence interval variables with P-values below 0.05 in multivariable analysis were declared as significant variables. Results: Of the total respondents, 68 were cases and 136 were controls, with an overall response rate of 98.55%. Of these respondents, 57.4% and 57.8% were males and type 1 diabetic patients, respectively. This study found that ages of 38-47 (AOR= 5.60 (1.62-19.38)) and >47 (AOR=4.81 (1.32-17.5)), income of 1000-1499 (AOR=3.10 (1.05-9.08)), self-reported drug adherence (AOR=5.146 (1.651-16.04)), FBS of 70-130 mg/dL 0.095 (0.022-0.414) and ≥131 mg/dL (0.05 (0.011-0.223)) and type 1 diabetic mellitus (AOR=4.73 (1.765-12.72)) were significantly associated with diabetes mellitus complications. Conclusion and Recommendations: The study identified important determinants of diabetic complications. Poor glycemic control, poor adherence, and income were found to be modifiable determinants; on the other hand, age and type of diabetic mellitus are nonmodifiable determinants of diabetic complications. Clinicians should implement a comprehensive care plan that will address patients' adherence and glycemic control problems.

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“…Another hypothesis is related to the fact that individuals may not have access to more appropriate shoes, given a lack of financial resources. A case control study analyzing factors associated with amputations among individuals with DM verified that people who did not wear appropriate shoes were 4.75 times more likely to suffer an amputation that those who did 18 . …”

Section: Discussionmentioning

confidence: 99%

Differences in foot self-care and lifestyle between men and women with diabetes mellitus

Rossaneis

Haddad

Mathias

et al. 2016

Rev. Latino-Am. Enfermagem

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Objective:to investigate differences with regard to foot self-care and lifestyle between men and women with diabetes mellitus.Method: cross-sectional study conducted in a sample of 1,515 individuals with diabetes mellitus aged 40 years old or older. Poisson regression models were used to identity differences in foot self-care deficit and lifestyle between sexes, adjusting for socioeconomic and clinical characteristics, smoking and alcohol consumption.Results: foot self-care deficit, characterized by not regularly drying between toes; not regularly checking feet; walking barefoot; poor hygiene and inappropriately trimmed nails, was significantly higher among men, though men presented a lower prevalence of feet scaling and use of inappropriate shoes when compared to women. With regard to lifestyle, men presented less healthy habits, such as not adhering to a proper diet and taking laboratory exams to check for lipid profile at the frequency recommended. Conclusion: the nursing team should take into account gender differences concerning foot self-care and lifestyle when implementing educational activities and interventions intended to decrease risk factors for foot ulceration.

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

Cited by 27 publications

References 14 publications

The importance of HbA1C and erythrocyte sedimentation rate as prognostic factors in predicting the outcome of diabetic foot ulcer disease

The importance of HbA1C and erythrocyte sedimentation rate as prognostic factors in predicting the outcome of diabetic foot ulcer disease

<p>Determinants of Diabetic Complication Among Adult Diabetic Patients in Debre Markos Referral Hospital, Northwest Ethiopia, 2018: Unmatched Case Control Study</p>

Differences in foot self-care and lifestyle between men and women with diabetes mellitus

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