Risk Factors For Major Amputation On Hindfoot Ulcers In Hospitalized Diabetic Patients
Seung Kyu Han, Jae youn Kim, Ji Won Son, Sik Namgoong.
Korea University Guro Hospital, seoul, Korea, Republic of.
Approach: Between January 2003 and October 2017, a total of 1,657 diabetic patients were admitted to the diabetic wound center of Korea University Guro Hospital for foot ulcers. Among them, 117 diabetic patients with hindfoot ulcers were included in this study. One hundred and four patients (89%) healed without major amputation while 13 patients (11%) healed with major amputation. Data of 88 potential risk factors including demographics, ulcer condition, vascularity, bioburden, neurology, and serology were collected from patients in these two groups and compared. Results: Among these 88 potential risk factors, 15 risk factors showed statistically significant differences between the two groups. In univariate analysis carried out for 88 potential risk factors, statistically significant differences were observed for nine risk factors. In stepwise multiple logistic analysis, three of these nine risk factors remained statistically significant. Multivariate-adjusted odds ratios for pulmonary disorders, erythrocyte sedimentation rate (ESR) levels, and total iron-binding capacity (TIBC) levels were 38.525, 1.047, and 0.976, respectively. Innovation: Diabetic foot ulcers located at the hindfoot are closely associated with major amputation because of their proximity. However, there are only few studies on large cohorts that specifically discuss outcomes and characteristics of hindfoot ulcers. Conclusion: Risk factors for major amputation in diabetic hindfoot patients were pulmonary disorders, high levels of ESR, and decreased TIBC levels.
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