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A foot risk classification system to predict diabetic amputation in Pima Indians
J A Mayfield1, G E Reiber, R G Nelson
1Bowen Research Center, Indiana University, Indianapolis, USA.
Diabetes Care
|July 1, 1996
Summary
Diabetic patients with male sex, end-organ complications, or foot issues like neuropathy face higher amputation risks. A scoring system can help predict these risks.
Area of Science:
- Diabetes Mellitus Research
- Podiatric Medicine
- Public Health Epidemiology
Background:
- Diabetic foot complications represent a significant global health burden.
- Identifying key risk factors is crucial for preventing lower extremity amputations in diabetic populations.
Purpose of the Study:
- To determine the contribution of various risk factors to lower extremity amputation risk in diabetic patients.
- To develop a clinical data-based foot risk scoring system for amputation prediction.
Main Methods:
- A population-based case-control study was conducted.
- Included diabetic individuals aged 25-85 from the Gila River Indian Community.
- Compared medical records of 61 amputation cases with 183 controls.
Main Results:
- Male sex (OR 6.5) and diabetic end-organ complications (OR 4.6) increased amputation risk.
- Peripheral neuropathy, vascular disease, deformities, and prior ulcers were equally associated with increased risk.
- Amputation risk escalated with the number of foot risk factors (OR 9.7 for 3-4 factors).
Conclusions:
- Male sex, eye, kidney, and heart complications, and poor glucose control are linked to higher amputation rates.
- Peripheral neuropathy, vascular disease, foot deformity, and prior ulcers significantly elevate lower extremity amputation risk.
- These findings support the development of a predictive foot risk scoring system.