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Predictive values of risk factors in management of diabetic foot

Authors: Safa M..Al-Obaidi صفاء العبيدي --- Amine Mohammed Bakkour --- Salah Mahdi Tajer
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 37-43
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Outcome of management of patients with diabetic foot is difficult to predict. Assessmentof variables in history , examination and investigations were analyzed with outcome of management andwhether can be assigned as prognostic factors .Methods: prospective study of 300 patients with diabetic foot in Baghdad teaching hospital duringthe period from April 2000 to March 2004,certain criteria was taken in history and examination, thesewere investigated and treated either by conservative procedure or amputation.Results: most common age group was 50-59 years ( 33.3%). The male to female ratio was 2:1.Conservative debridement was performed in ( 60%) of patients while amputation was employed in(40%). amputation was performed in 604 in patient above 60 years and in(75%) of patients who haddiabetic foot lesions for > 2 weeks,and in 90% of smokers for 10 years or more. Amputation wasneeded in (71%) in those who had history of previous ulceration and 72.5% of patients who hadpositive history of previous amputation. Amputation was needed in (88%) of those who had theirtemperature >38°C. in (91%) of patients who had diabetic foot lesion of Wagner grade>III and 91%.patients with X-ray findings of osteomyelitis.Conclusions: Highly significant association was found between amputation with following variable ,smokers > 10 years, patients with a temperature of > 38°C, Hypertension > 140/90 mmHg Wagnergrade > III, white blood cell count of > 20,000/cc and positive foot X-ray findings. Slightsignificant association of amputation and the following variables: Age >60 years, duration of footlesion >2 weeks, history of previous amputation, previous ulceration, negative pedal pulses, deformedfeet and patients who had impaired normal vision.

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