The strongest predictor of major amputation in diabetic foot ulcers: Peripheral arterial disease; frequency and related factors
Background and Aim: Diabetic foot ulcers and the resulting lower-extremity major amputations are common and mortal complications of diabetes. More than half of the diabetic foot ulcers are due to peripheral arterial disease. The aim of this study is to evaluate the frequency and related factors of peripheral arterial disease and to show the effect of peripheral arterial disease on major amputation for diabetic foot ulcers.
Methods: Follow-up forms of 123 diabetic foot patients who were treated at the chronic wound and infections care unit between September 2016 and August 2017 were evaluated retrospectively.
Results: Among the study patients, 65% of them were males and the mean age was 59.7±11.7. Peripheral arterial disease was present in 66.7% of the patients. During the treatment 13.8% of patients underwent major lower extremity amputation. According to multiple logistic regression analysis peripheral arterial disease was found to be higher 15.5-fold for the major amputation group. Significant correlations were found between peripheral arterial disease and hypertension (p<0.001), median age (p<0.001), diabetes duration (p=0.023), chronic kidney disease (p=0.042) and HbA1c (p=0.003).
Conclusions: We found in this study that peripheral arterial disease is very common in patients with diabetic foot ulcers and the major amputation rates increase with peripheral arterial disease presence. Therefore for all the patients with diabetic foot ulcers, peripheral arterial disease should be investigated and the treatments should be planned rapidly.
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