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[Evaluation of diabetic foot amputation rate]
Cláudia Horta1, Joana Vilaverde, Paula Mendes
1Serviços de Endocrinologia, Ortopedia e Cirurgia Vascular, Hospital Geral de Santo António, Porto.
Acta Medica Portuguesa
|January 6, 2005
Summary
The first Portuguese Diabetic Foot Clinic saw major amputation rates stabilize around 8% by 1995. Recent data shows a slight reduction to 5.2%, with necrosis and ischemic foot posing the poorest prognosis for diabetic patients.
Area of Science:
- Podiatry
- Diabetology
- Vascular Surgery
Context:
- The establishment of the first Portuguese Diabetic Foot Clinic in 1987 significantly reduced major amputations.
- Amputation rates stabilized around 8% until 1995.
- This study evaluates amputation rates in the subsequent three years.
Purpose:
- To assess changes in major amputation rates for diabetic foot patients between 1998 and 2000.
- To identify risk factors and prognostic indicators for major amputations in diabetic foot complications.
Summary:
- A retrospective analysis of 593 diabetic patients with foot ulcers or infections (1998-2000) revealed a 5.2% major amputation rate.
- Neuropathic foot (60.4%) and ischemic foot (39.6%) showed statistically significant differences in amputation outcomes (p < 0.001).
- Necrosis presented a poor prognosis, particularly in ischemic feet (30.7% vs. 8.3% in neuropathic feet, p = 0.024).
Impact:
- The study indicates a slight decrease in major amputations compared to previous periods.
- Ischemic foot and necrosis are identified as key predictors of poor outcomes.
- Enhanced patient education and primary care physician awareness are crucial for preventing diabetic foot complications.