Predictors of Lower Extremity Amputations in Patients with Diabetic Foot Ulcers and Management Outcome

Diabetic foot ulcer is an associated and an increasing problem among individuals with diabetes. The aim of the present study was to evaluate the risk factors for amputation in patients with diabetic foot ulcer as well as common causes of increasing mortality in these patients.

The design was an observational prospective study carried out between July 2015 and June 2018. The Demographic data of all patients with diabetic foot ulcer seen at Lagos University Teaching Hospital and Nigerian Navy Reference Hospital Lagos with their clinical signs and symptoms as well as basic laboratory results were documented. The ankle brachial index (ABI), history of neuropathy, nephropathy and the relationship between these and lower limb amputation and mortality were collected and analyzed.

There were 539 patients with diabetic foot ulcer seen during the 3-year period. The mean age was 62 + 13.7. There was male preponderance with a ratio of 1.7:1. Patient with amputation more often had ABI <0.9. Male sex is a risk factor for amputation. Over 40.5% of the patients had grade I ulcer, 19.5% had grade II, while 22.3%, 12.3% and 5.4% had grade III, IV and V respectively. Amputations were performed in 144(26.7%) patients (48 minor, 96 major). Compared with patients without amputation, patients with amputation differed significantly concerning diabetes and its complications. Mortality rate was 11.8%.