ANALYSIS OF THE TYPES AND PATTERNS OF LIMB AMPUTATIONS RELATED TO DIABETIC FOOT CONDITIONS IN THE QASSIM REGION: A...

Diabetic foot ulcers (DFUs) are a significant complication of diabetes, frequently leading to limb amputations. This study analyzes the patterns and types of amputations associated with DFUs in the Qassim region, Saudi Arabia, addressing a gap in regional data.

A retrospective study was conducted at the Sheikh Fahad Alawidah Diabetic Foot Center, Buraidah, Qassim, Saudi Arabia, including all patients diagnosed with DFUs who underwent amputations between January 2020 and September 2024. Data on demographics, diabetes-related characteristics, and amputation details were collected using a pre-designed checklist and analyzed using SPSS version 26. Below-knee and above-knee amputations were considered major, whereas toe and transmetatarsal amputations were considered minor.

Among 241 patients, the majority were male 165 (68.5%) and over 60 years old 140 (58.1%). Most patients had type 2 diabetes 238 (98.8%). Regarding amputation patterns, 187 (77.6%) underwent minor amputations, 73 (30.3%) major amputations, and 19 (7.9%) had both types; overall, 168 (69.7%) had minor amputations only and 54 (22.4%) had major amputations only. Below-knee amputations 58 (79.5%) were the most common major procedures, while other toes amputations 97 (52.1%) predominated among minor amputations. Infection 128 (53.1%) and critical ischemia 73 (30.3%) were the leading causes of amputation. Significant associations were identified between amputation type and variables such as chronic diseases, ICU admission, and infection history. Multivariate logistic regression analysis further showed that ICU admission (OR=6.15, p<0.001), more than four hospital admissions (OR=3.54, p=0.002), chronic diseases (OR=3.12, p=0.048), diabetic nephropathy (OR=2.87, p=0.033), cardiovascular disease (OR=2.41, p=0.016), infection (OR=2.76, p=0.006), and previous surgery (OR=2.11, p=0.021) were independent predictors of major amputation. Higher white blood cell count (OR=1.08, p=0.002) and creatinine levels (OR=1.04, p=0.008) were also associated with increased risk, while higher hemoglobin levels were as-sociated with a lower risk (OR=0.79, p=0.003).

This study highlights the prevalence of minor amputations and the critical role of infections in DFU-related amputations in the Qassim region. Targeted prevention strategies and early intervention are essential to reduce the burden of amputations and improve patient outcomes.