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Published on: September 22, 2020
Partial proportional odds model for predicting multiple lower extremity amputation among T2DM patients.
Sabiha Khan1,2, Karuna Reddy3, Momtaz Ahmed4
1School of Information Technology, Engineering, Mathematics & Physics, The University of the South Pacific, Suva, Fiji. sabiha.khan@fnu.ac.fj.
Identifying risk factors for multiple lower extremity amputations (MLEA) in diabetic patients is crucial. A partial proportional odds model identified age, gender, ethnicity, hypertension, anemia, leukocytosis, and thrombocytosis as key predictors in T2DM patients in Fiji.
Area of Science:
- Diabetic foot complications
- Amputation risk factors
- Statistical modeling in healthcare
Background:
- Multiple lower extremity amputation (MLEA) presents greater challenges than single amputation for diabetic patients.
- Accurate identification of MLEA risk factors is essential for prevention in diabetic populations.
Purpose of the Study:
- To explore demographic and clinical characteristics of diabetic inpatients with foot ulcers.
- To develop a statistical model for identifying MLEA risk factors in type 2 diabetes mellitus (T2DM) patients.
Main Methods:
- A cross-sectional study analyzed data from 1,972 T2DM patients hospitalized for diabetic foot ulcers in Fiji (2016-2019).
- A partial proportional odds model (PPOM) was developed to predict ordinal outcomes: no amputation, primary amputation, and MLEA.
- The PPOM was validated against proportional odds and multinomial logistic regression models.
Main Results:
- The PPOM identified significant risk factors for MLEA.
- Key predictors included advanced age, specific gender and ethnicity, hypertension, anemia, leukocytosis, and thrombocytosis.
Conclusions:
- The partial proportional odds model is suitable for determining MLEA risk factors in T2DM patients in Fiji.
- Findings can inform targeted interventions to reduce amputation rates.
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