ABSTRACT

Diabetic foot infections (DFI) are a frequent complication of diabetes mellitus and 15-20% of them result in amputation. Identifying the risk factors that predispose to amputation in this group of patients can help prevent amputation and plan the appropriate medical treatments. In this study, we aim to determine amputation frequency and risk factors related to amputation in patients with DFI, who were followed up in our clinic in the last five years.

Our study is a retrospective descriptive study. Patients were divided into two groups according to the amputation application. Age, gender, duration of diabetes, antidiabetic therapy, Wagner classification, wound width, wound time, peripheral artery disease (PAD), hypertension (HT), chronic kidney failure, osteomyelitis (OM) history, hyperbaric oxygen therapy application, total antimicrobial treatment duration, presence of fever before treatment, leukocyte, sedimentation, C-reactive protein, creatinine, and HBA1c levels were compared. The frequency of amputation was calculated, and independent risk factors were determined between univariate and multivariate logistic regression tests between the groups with and without amputation.

The frequency of amputation was found to be 39.7% in 146 patients included in the study. It was found that amputation was more common in patients with Wagner wound classification score >2, with PAD, HT, OM, and in patients with a leukocyte, C-reactive protein, high sedimentation level, and wound width 11-15 cm2. It was determined that the Wagner wound classification score ≤2 and absence of PAD reduced these factors, and that the wound between 11 and 15 cm2 increased the risk of amputation by 8.2 times.

In order to prevent limb loss in patients with DFI, it may be a suitable approach to resolve the circulation problem rapidly and to treat in the early period when the wound is more superficial and smaller in terms of surface area.

Keywords: Diabetic Foot Infection, Amputation, Risk Factor