Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients

Qingwei Lu,1 Jun Wang,1 Xiaolu Wei,2 Gang Wang,1 Yang Xu1 1Department of Ulcers and Peripheral Vascular Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300193, People&...

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Autores principales:	Lu Q, Wang J, Wei X, Wang G, Xu Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic foot ulcers risk factors major amputation minor amputation retrospective analysis Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/155bdb1381d54ed996b9457a4ecb3c5e
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spelling	oai:doaj.org-article:155bdb1381d54ed996b9457a4ecb3c5e2021-12-02T17:01:03ZRisk Factors for Major Amputation in Diabetic Foot Ulcer Patients1178-7007https://doaj.org/article/155bdb1381d54ed996b9457a4ecb3c5e2021-05-01T00:00:00Zhttps://www.dovepress.com/risk-factors-for-major-amputation-in-diabetic-foot-ulcer-patients-peer-reviewed-fulltext-article-DMSOhttps://doaj.org/toc/1178-7007Qingwei Lu,1 Jun Wang,1 Xiaolu Wei,2 Gang Wang,1 Yang Xu1 1Department of Ulcers and Peripheral Vascular Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300193, People’s Republic of China; 2School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, 264003, People’s Republic of ChinaCorrespondence: Jun Wang; Gang WangDepartment of Ulcers and Peripheral Vascular Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People’s Republic of ChinaEmail tjzywangjun@126.com; doctorwanggang@sina.comAbstarct: Background: The purpose of our study was to identify the new and the more specific risk factors for major amputation in patients with diabetic foot ulcer (DFU).Methods: We used data from the Electronic Medical Record (EMR) database of our hospital from February 2014 to July 2020. Patients with DFU and amputation were included in the study. The logistic regression model was adjusted for demographic characteristics and related comorbidities between major and minor amputation groups.Results: Among 3654 patients with DFU, 363 (9.9%) were amputated. Patients with major versus minor amputation, in multivariable logistic regression models, major amputation independent factors included previous amputation history (odds ratio [OR] 2.31 [95% CI 1.17– 4.53], p = 0.02), smoking (2.58 [1.31– 5.07], p = 0.01), coronary artery disease (CAD) (2.67 [1.35– 5.29], p = 0.03), ankle brachial index (ABI) < 0.4 (15.77 [7.51– 33.13], p < 0.01), Wagner 5 (5.50 [1.89– 16.01], p < 0.01), activated partial thromboplastin time (APTT) (1.23 [1.03– 1.48], p = 0.01), glycosylated hemoglobin A1c (HbA1c) (1.23 [1.03– 1.48], p = 0.03), hemoglobin (Hb) (0.98 [0.96– 1.00], p = 0.01), plasma albumin (ALB) (0.88 [0.81– 0.95], p < 0.01) and white blood cell (WBC) (1.10 [1.04– 1.16], p < 0.01).Conclusion: Major amputation was associated with previous amputation history, smoking, CAD, Wagner 5, ABI < 0.4, HbA1c, Hb, ALB, WBC, and APTT might be a new independent factor. In view of these factors, early prevention and guidance promptly orientated by multidisciplinary is of great significance to reduce the disability rate and economic burden.Keywords: diabetic foot ulcers, risk factors, major amputation, minor amputation, retrospective analysisLu QWang JWei XWang GXu YDove Medical Pressarticlediabetic foot ulcersrisk factorsmajor amputationminor amputationretrospective analysisSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 2019-2027 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic foot ulcers risk factors major amputation minor amputation retrospective analysis Specialties of internal medicine RC581-951
spellingShingle	diabetic foot ulcers risk factors major amputation minor amputation retrospective analysis Specialties of internal medicine RC581-951 Lu Q Wang J Wei X Wang G Xu Y Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
description	Qingwei Lu,1 Jun Wang,1 Xiaolu Wei,2 Gang Wang,1 Yang Xu1 1Department of Ulcers and Peripheral Vascular Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300193, People’s Republic of China; 2School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, 264003, People’s Republic of ChinaCorrespondence: Jun Wang; Gang WangDepartment of Ulcers and Peripheral Vascular Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People’s Republic of ChinaEmail tjzywangjun@126.com; doctorwanggang@sina.comAbstarct: Background: The purpose of our study was to identify the new and the more specific risk factors for major amputation in patients with diabetic foot ulcer (DFU).Methods: We used data from the Electronic Medical Record (EMR) database of our hospital from February 2014 to July 2020. Patients with DFU and amputation were included in the study. The logistic regression model was adjusted for demographic characteristics and related comorbidities between major and minor amputation groups.Results: Among 3654 patients with DFU, 363 (9.9%) were amputated. Patients with major versus minor amputation, in multivariable logistic regression models, major amputation independent factors included previous amputation history (odds ratio [OR] 2.31 [95% CI 1.17– 4.53], p = 0.02), smoking (2.58 [1.31– 5.07], p = 0.01), coronary artery disease (CAD) (2.67 [1.35– 5.29], p = 0.03), ankle brachial index (ABI) < 0.4 (15.77 [7.51– 33.13], p < 0.01), Wagner 5 (5.50 [1.89– 16.01], p < 0.01), activated partial thromboplastin time (APTT) (1.23 [1.03– 1.48], p = 0.01), glycosylated hemoglobin A1c (HbA1c) (1.23 [1.03– 1.48], p = 0.03), hemoglobin (Hb) (0.98 [0.96– 1.00], p = 0.01), plasma albumin (ALB) (0.88 [0.81– 0.95], p < 0.01) and white blood cell (WBC) (1.10 [1.04– 1.16], p < 0.01).Conclusion: Major amputation was associated with previous amputation history, smoking, CAD, Wagner 5, ABI < 0.4, HbA1c, Hb, ALB, WBC, and APTT might be a new independent factor. In view of these factors, early prevention and guidance promptly orientated by multidisciplinary is of great significance to reduce the disability rate and economic burden.Keywords: diabetic foot ulcers, risk factors, major amputation, minor amputation, retrospective analysis
format	article
author	Lu Q Wang J Wei X Wang G Xu Y
author_facet	Lu Q Wang J Wei X Wang G Xu Y
author_sort	Lu Q
title	Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
title_short	Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
title_full	Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
title_fullStr	Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
title_full_unstemmed	Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients
title_sort	risk factors for major amputation in diabetic foot ulcer patients
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/155bdb1381d54ed996b9457a4ecb3c5e
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_version_	1718382194784731136

Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients

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