The Effect of Age, Gender, Risk Level and Glycosylated Hemoglobin in Predicting Foot Amputation in HMO Patients with Diabetes

Abstract

Purpose To determine if age, gender, risk level and glucosylated hemoglobin could predict foot amputations in HMO patients with diabetes. Data Sources A retrospective chart review of a non‐random sample of 27 patients with amputation and 110 randomly selected patients without amputation during the same time period. Chi‐square, t‐tests and logistic regression were used to analyze the data. Conclusions There was no significant difference between the group with amputation and those without amputation in age or gender. However, there was a significant difference between the two groups in the risk stratification (p=.005) and glycosylated hemoglobin levels (p=.058). Implications for Practice Nurse practitioners can effectively screen for amputation risk factors and closely monitor glycosylated hemoglobin levels of diabetic patients to reduce the incidence of vascular complications and related lower extremity amputation.

Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus—review and meta-analysis

“…Description of studies Fourteen prospective studies [2,10,12,[20][21][22][23][32][33][34][35][36][37][38] involving 94,640 participants and 1,227 LEA cases were included. Details of study characteristics are provided ( Table 1).…”

“…The studies were North American and European, with the exception of two, which were conducted in Australia [38] and Jordan [37]. Three studies [10,22,37] had a nested case-control design, the rest had a cohort design. The proportion of men in the studies ranged between 33% and 98% (weighted average 85%).…”

“…Lower extremity amputation (LEA) is a serious complication of diabetes related to both macro-and microangiopathic changes [10][11][12]. Diabetic individuals have a markedly increased risk of LEA when compared with nondiabetic individuals [13,14], with potentially grave consequences; thus those with LEAs die earlier on average than those without amputations [15].…”

Les facteurs pronostiques dans l’amputation du pied chez le diabétique

“…We divided the patients into two groups, the first one of the amputed [28] and the second one of the non amputed [29].…”

“…Des critères prédéterminés ont été choisis pour le diagnostic et la prise en charge des lésions. Nous avons réparti les patients en deux groupes, le premier comprenait les patients amputés [28] et le deuxième les patients non amputés [29]. Une analyse bivariée a été effectuée rétrospectivement pour mettre en évidence les facteurs associés à l'amputation.…”