Background: Diabetes is a life-changing disease associated with the severe morbidity and also mortality. Among the diabetic patients, the prevalence of foot ulcers will usually be as high as 20%. These ulcers usually become infected, cause very high morbidity, and are the usual first step for lower extremity amputation. The holistic care of diabetic foot ulcers requires a multidisciplinary approach. Apart from blood sugar control, treatment of ulcer involves wound debridement, appropriate dressings, vascular maintenance, and control of infections. The most important factor in preventing amputation is a repeated education of the patient in foot care and to really look into factors associated with amputation. This review article is an attempt to identify the statistically significant risk factors leading to lower extremity amputation. Materials and methods: The research literature was searched for various studies reporting the risk factors for lower extremity amputation in patients with DFI. A systematic search of literature was conducted first in MEDLINE/PubMed and then in Cochrane Central Register of Controlled Trials till July 2019. This search retrieved 11 most relevant articles. The risk factors that led to LEA were studied and data were analyzed. Results: Based on the comparison, we have concluded that male preponderance, duration of diabetes, and vasculopathy were found to be statistically significant in majority of the studies.
Shin JY, Roh S-G, Sharaf B, Lee N-H. Risk of major limb amputation in diabetic foot ulcer and accompanying disease: a meta-analysis. J Plast Reconstr Aesthetic Surg 2017;70(12):1681–1688. DOI: 10.1016/j.bjps.2017.07.015.
Aziz Z, Lin WK, Nather A, Huak CY. Predictive factors for lower extremity amputations in diabetic foot infections. Diabet Foot Ankle 2011. 2. DOI: 10.3402/dfa.v2i0.7463.
Shojaiefard A, Khorgami Z, Larijani B. Independent risk factors for amputation in diabetic foot. Int J Diabetes Dev Ctries 2008;28(2): 32–37. DOI: 10.4103/0973-3930.43096.
Diabetic Foot Infections - American Family Physician [Internet]. [cited 2020 Jan 11]. Available from: https://www.aafp.org/afp/2013/0801/p177.html.
Prompers L, Huijberts M, Apelqvist J, Jude E, Piaggesi A, Bakker K, et al. High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia 2007;50(1):18–25. DOI: 10.1007/s00125-006-0491-1.
Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004;39(7):885–910. DOI: 10.1086/424846.
Lavery LA, Peters EJG, Armstrong DG. What are the most effective interventions in preventing diabetic foot ulcers? Int Wound J 2008;5(3):425–433. DOI: 10.1111/j.1742-481X.2007.00378.x.
Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. Ingelfinger JR, editor. N Engl J Med 2017;376(24): 2367–2375.
Wukich DK, Hobizal KB, Sambenedetto TL, Kirby K, Rosario BL. Outcomes of osteomyelitis in patients hospitalized with diabetic foot infections. Foot Ankle Int 2016;37(12):1285–1291. DOI: 10.1177/1071100716664364.
Cervantes-García E, Salazar-Schettino PM. Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico. Diabet Foot Ankle 2017;8(1):1367210. DOI: 10.1080/2000625X.2017.1367210.
Mehmood K, Akhtar ST, Talib A, Talib A, Abbasi B, Siraj-ul-Salekeen, et al. Clinical profile and management outcome of diabetic foot ulcers in a tertiary care hospital. J Coll Physicians Surg Pak 2008;18(7): 408–412.
Uysal S, Arda B, Taşbakan MI, Çetinkalp Ş, Şimşir IY, Öztürk AM, et al. Risk factors for amputation in patients with diabetic foot infection: a prospective study. Int Wound J 2017;14(6):1219–1224. DOI: 10.1111/iwj.12788.
Al-Maskari F, El-Sadig M. Prevalence of risk factors for diabetic foot complications. BMC Fam Pract 2007;8:59. DOI: 10.1186/1471-2296-8-59.
Casellini CM, Vinik AI. Clinical manifestations and current treatment options for diabetic neuropathies. Endocr Pract 2007;13(5):550–566. DOI: 10.4158/EP.13.5.550.
Van Damme H, Limet R. Amputation in diabetic patients. Clin Podiatr Med Surg 2007;24(3):569–582. DOI: 10.1016/j.cpm.2007.03.007.
Alwakeel JS, Isnani AC, Alsuwaida A, AlHarbi A, Shaikh SA, AlMohaya S, et al. Factors affecting the progression of diabetic nephropathy and its complications: a single-center experience in Saudi Arabia. Ann Saudi Med 2011;31(3):236–242. DOI: 10.4103/0256-4947.81528.
Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008;88(11):1254–1264. DOI: 10.2522/ptj.20080020.
Formosa C, Gatt A, Chockalingam N. Screening for peripheral vascular disease in patients with type II diabetes in Malta in a primary care setting. Qual Prim Care 2012;20(6):409–414.
Dalla Paola L, Faglia E. Treatment of diabetic foot ulcer: an overview strategies for clinical approach. Curr Diabetes Rev 2006;2(4):431–447. DOI: 10.2174/1573399810602040431.