Abstract:

[Abstract] Objective  To analyze risk factors of lower extremity amputations in patients with severe infective diabetic foot ulcers. Methods  The total of 1 076 patients with diabetic foot ulcers was included in this study. All patients with severe diabetic foot infections were selected (PEDIS grade 3-4) by PEDIS infection classification，and divided into three groups including non-amputation group (group A，n=48),healing after minor amputations (group B，n =162) and administered amputations above ankle-level (group C, n=70). The biochemical indicators and SAD score were measured and compared in groups of patients. The multiple Logistic regression analysis was used to observe the factors affect small amputation (toe) and amputation. Results  The multivariate analysis showed that platelet count, serum uric acid and the degree of peripheral vascular diseases (SAD score) were independent predictors of minor amputations in the patients with severe infections. Besides the above factors，the plasma fibrinogen and the depth of ulcer (scored by SAD) were the factors related to the risk of major amputation. Conclusion  It was found that the platelet count, serum uric acid, plasma fibrinogen, the Charlson score, the degree of peripheral vascular diseases and the depth of ulcer can predict the amputation-risk in diabetic foot patients with severe infections.

Key words: amputation, diabetic foot, ulcer, wound infection