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Risk factors for amputation in patients with diabetic foot infection: a prospective study
Authors:Serhat Uysal  Bilgin Arda  Meltem I Taşbakan  Şevki Çetinkalp  Ilgın Y Şimşir  Anıl M Öztürk  Ayşe Uysal  İlgen Ertam
Affiliation:1. Department of Infectious Diseases and Clinical Microbiology, Ege University Medical Faculty, Izmir, Turkey;2. Department of Endocrinology and Metabolism, Ege University Medical Faculty, Izmir, Turkey;3. Department of Orthopedics and Traumatology, Ege University Medical Faculty, Izmir, Turkey;4. Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey;5. Department of Dermatology, Ege University Medical Faculty, Izmir, Turkey
Abstract:
There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (33·2%) underwent amputation. The odds ratios in the amputation model were 3·09 for osteomyelitis (P < 0·001), 4·90 for arterial stenosis (AS) (P < 0·001), 3·67 for the history of DFI (P = 0·001), 2·47 for ulcer duration >60 days (P = 0·001), 3·10 for ulcer depth > 15 mm (P < 0·001) and 10·28 for fungal DFI (P = 0·015). In this study, the unusual result of well‐known literature was fungal DFI as an independent risk factor for amputation in patients with DFI.
Keywords:Amputation  Diabetic foot  Fungal infection  Osteomyelitis  Wound depth  Wound duration
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