Endocrine Abstracts

Introduction: Lower limb amputation is associated with high morbidity and mortality. As a middle-income country, we are particularly vulnerable to diabetes-related problems. The aim of this study is to identify significant risk factors for amputations.

Materials and methods: This is a prospective descriptive study conducted from June 2020 to June 2022 on 102 patients hospitalized for diabetic foot at the Endocrinology-Diabetology Department of Oran University Hospital. The patients were divided into two categories according to the outcome: amputation or non-amputation. To identify the risk factors, we performed a bivariate analysis using SPSS 20 to compare the two groups.

Results: The study included 102 diabetes patients (50 men and 52 women) with a mean age of 63±1 year. Of the 102 patients, 58 (56.9%) had undergone an amputation. Univariate analysis identified insulin therapy prior to admission (OR = 8.2, CI [1.7–40]; P= 0.003), dry gangrene lesion (OR = 8.6, CI [3.4–21.7]; P= 0.000001), and osteitis (OR = 4; CI [1.5–10.5]; P= 0.004) as risk variables. The study found significant associations between HbA1c levels and several complications, including retinopathy (OR = 3.5; CI [1.5-8.1]; P= 0.004), macroangiopathic complications (OR = 2.7 CI [1.1-6.7]; P= 0.032), peripheral neuropathy (OR = 3.3 CI [1.4-7.8]; P= 0.007), and arterial stenosis (OR = 6.6 CI [2-21]; P= 0.001). Independent predictive markers were male gender, prevalence of neuropathy, and hospital stay longer than 33.5 days.

Conclusion: Identifying risk factors for amputation is crucial to offering effective preventative strategies based on patient and caregiver education and early diagnosis of lesions.