Scoring System for Assessing Risk of Amputation in Patient's With Diabetic Foot

Abstract

Diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and society. Our aim is “To formulate a risk scoring system that can predict the risk of amputation in a patient with an infected diabetic foot”. Previously published studies aimed at identifying independent risk factors for lower-extremity amputation in patients with a DFI have noted an association with older age, the presence of fever, elevated acute-phase reactants, higher HbA1c levels, and renal insufciency. In the current study, we have identied that Age, Duration of diabetes, History of amputations, Ulcer depth, Ankle-brachial index, Severity of infection, and Peripheral neuropathy, Peripheral arterial diseases are signicantly associated with Lower Extremity amputation. Peripheral vascular disease and infection were the most powerful predictors, as 65% of patients who underwent amputations in our study belonged to Rutherford grade 3 and grade 4. We developed a New Risk score for predicting amputation in diabetic patients with an infected foot ulcer, which can be readily used in daily clinical practice without the necessity of extensive lab investigations. Patients with a score of >16.5 are at increased risk of lower extremity amputation. 66.6% of our follow up cases who underwent reamputations belonged to the group with a score of >16.5. Risk of amputation increases as the score increases