Tags

Type your tag names separated by a space and hit enter

Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems.
Singapore Med J 2015; 56(11):626-31SM

Abstract

INTRODUCTION

Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.

METHODS

This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.

RESULTS

A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.

CONCLUSION

T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.

Authors+Show Affiliations

Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Community Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.Department of Orthopaedic, Tawau Hospital, Sabah, Malaysia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26668408

Citation

Yusof, Nazri Mohd, et al. "Predictors of Major Lower Limb Amputation Among Type II Diabetic Patients Admitted for Diabetic Foot Problems." Singapore Medical Journal, vol. 56, no. 11, 2015, pp. 626-31.
Yusof NM, Rahman JA, Zulkifly AH, et al. Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems. Singapore Med J. 2015;56(11):626-31.
Yusof, N. M., Rahman, J. A., Zulkifly, A. H., Che-Ahmad, A., Khalid, K. A., Sulong, A. F., & Vijayasingham, N. (2015). Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems. Singapore Medical Journal, 56(11), pp. 626-31. doi:10.11622/smedj.2015172.
Yusof NM, et al. Predictors of Major Lower Limb Amputation Among Type II Diabetic Patients Admitted for Diabetic Foot Problems. Singapore Med J. 2015;56(11):626-31. PubMed PMID: 26668408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems. AU - Yusof,Nazri Mohd, AU - Rahman,Jamalludin Ab, AU - Zulkifly,Ahmad Hafiz, AU - Che-Ahmad,Aminudin, AU - Khalid,Kamarul Ariffin, AU - Sulong,Ahmad Fadzli, AU - Vijayasingham,Naveen, PY - 2015/12/16/entrez PY - 2015/12/17/pubmed PY - 2017/1/25/medline KW - amputation KW - diabetes mellitus KW - diabetic foot KW - lower limb KW - type II SP - 626 EP - 31 JF - Singapore medical journal JO - Singapore Med J VL - 56 IS - 11 N2 - INTRODUCTION: Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood. METHODS: This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis. RESULTS: A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis. CONCLUSION: T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/26668408/Predictors_of_major_lower_limb_amputation_among_type_II_diabetic_patients_admitted_for_diabetic_foot_problems_ L2 - https://sma.org.sg/UploadedImg/files/SMJ/5611/5611a4.pdf DB - PRIME DP - Unbound Medicine ER -