Risk factors for amputation in patients with diabetic foot infection: a prospective study

Int Wound J. 2017 Dec;14(6):1219-1224. doi: 10.1111/iwj.12788. Epub 2017 Jul 19.

Abstract

There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (33·2%) underwent amputation. The odds ratios in the amputation model were 3·09 for osteomyelitis (P < 0·001), 4·90 for arterial stenosis (AS) (P < 0·001), 3·67 for the history of DFI (P = 0·001), 2·47 for ulcer duration >60 days (P = 0·001), 3·10 for ulcer depth > 15 mm (P < 0·001) and 10·28 for fungal DFI (P = 0·015). In this study, the unusual result of well-known literature was fungal DFI as an independent risk factor for amputation in patients with DFI.

Keywords: Amputation; Diabetic foot; Fungal infection; Osteomyelitis; Wound depth; Wound duration.

MeSH terms

  • Aged
  • Amputation, Surgical / methods*
  • Amputation, Surgical / statistics & numerical data
  • Diabetic Foot / microbiology*
  • Diabetic Foot / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycoses / surgery*
  • Osteomyelitis / microbiology
  • Osteomyelitis / surgery*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Wound Healing / physiology*
  • Wound Infection / surgery*