ECE2009 Poster Presentations Diabetes and Cardiovascular (103 abstracts)
Predictors of amputation in diabetic foot ulcer: single centre experience in a large Turkish cohort
Sena Yesil , Baris Akinci , Serkan Yener , Firat Bayraktar , Ozalp Karabay , Hasan Havitcioglu , Nur Yapar , Atay Atabey , Yasin Kucukyavas , Abdurrahman Comlekci & Sevinc Eraslan
Dokuz Eylul University, Izmir, Turkey.
Background: Prediction of diabetic foot ulcer outcome might be helpful for clinicians in optimizing individual treatment strategy. The aim of the present study was to determine potential benefits of easily assessed clinical and laboratory factors at baseline in the prediction of the outcome in patients with diabetic foot ulcers.
Methods: In this observational study, data was collected prospectively in 670 consecutive diabetic foot ulcer episodes in 510 patients between January 1999 and June 2008, and were used retrospectively to evaluate potential predictors of amputation. After exclusion of patients who did not attend to the hospital for follow-up visits for minimum 6 months, data of 574 foot ulcer episodes were evaluated.
Results: Limb ischemia, osteomyelitis, and presence of gangrene and ulcer depth, which were determined by Wagner classification system, were major independent predictors of overall and major amputations. Older age, presence of coronary artery disease, smoking and ulcer size were found to be associated with either overall or major amputations. Baseline levels of acute phase reactants (white blood cell count, polymorphonuclear leukocyte count, platelet count, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) and albumin) and decreased hemoglobin levels were associated with amputation risk. Multivariate analysis showed that one standard deviation increase in baseline CRP and ESR levels were independent predictors of overall and major amputations, respectively.
Conclusions: Presence of limb ischemia, osteomyelitis, local and diffuse gangrene and ulcer depth were determined as independent predictors of amputation. Baseline levels of ESR and CRP seemed helpful for clinicians in prediction of amputation.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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