Incidence, risk factors for amputation among patients with diabetic foot ulcer in a North Indian tertiary care hospital

ObjectiveAim of this study was to evaluate the incidence and risk factors for amputation among patients with diabetic foot ulcer (DFU).Research design and methodsWe performed a prospective study of 162 DFU in patients treated in a multidisciplinary based diabetes and endocrinology centre of Jawaharlal Nehru Medical College of Aligarh Muslim University, Aligarh, India during the period of December 2008–March 2011. Detailed history and physical examination was carried out for every subject. Risk factors for amputation were determined by univariate analysis with 95% of CI.ResultsThe overall amputation rate was 28.4%. On univariate analysis, male sex [OR 2.8, RR 1.28], hypertension [OR 2.83, RR 1.31], neuropathy [OR 3.01, RR 1.35], nephropathy [OR 2.24, RR 1.26], LDL-C (>100 mg/dl) [OR 2.53, RR 1.28], total cholesterol (>150 mg/dl) [OR 3.74, RR 1.52],HDLC(<40 mg/dl) [OR 1.19, RR 1.18], triglycerides (>200 mg/dl) [OR 5.44, RR1.76], previous antibiotic use [OR 9.12, RR 1.92], osteomyelitis [OR 6.97, RR 2.43] and biofilm infection [OR 4.52, RR 1.41] were significant risk factors.ConclusionThe risk factors for amputation were presence of PVD, leukocytosis, neuropathy, nephropathy, hypertension, dyslipidemia, over use of antibiotics, osteomyelitis, biofilm production and higher grade of ulcer.