Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

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...

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Main Authors:	Mohd Yusof, Nazri, Ab Rahman, Jamalludin, Zulkifly, Ahmad Hafiz, Che Ahmad, Aminudin, Khalid, Kamarul Ariffin, Sulong, Ahmad Fadzli, Vijayasingham, Naveen
Format:	Article
Language:	English
Published:	Singapore Medical Association 2015
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/45855/ http://irep.iium.edu.my/45855/ http://irep.iium.edu.my/45855/1/predictors_amputation_dfu_smj.pdf

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recordtype	eprints
spelling	iium-458552017-05-17T03:14:19Z http://irep.iium.edu.my/45855/ Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems Mohd Yusof, Nazri Ab Rahman, Jamalludin Zulkifly, Ahmad Hafiz Che Ahmad, Aminudin Khalid, Kamarul Ariffin Sulong, Ahmad Fadzli Vijayasingham, Naveen RD701 Orthopedics 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. Singapore Medical Association 2015-11 Article PeerReviewed application/pdf en http://irep.iium.edu.my/45855/1/predictors_amputation_dfu_smj.pdf Mohd Yusof, Nazri and Ab Rahman, Jamalludin and Zulkifly, Ahmad Hafiz and Che Ahmad, Aminudin and Khalid, Kamarul Ariffin and Sulong, Ahmad Fadzli and Vijayasingham, Naveen (2015) Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems. Singapore Medical Journal, 56 (11). pp. 626-631. ISSN 0037-5675 http://smj.sma.org.sg/smjcurrent.html
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Mohd Yusof, Nazri Ab Rahman, Jamalludin Zulkifly, Ahmad Hafiz Che Ahmad, Aminudin Khalid, Kamarul Ariffin Sulong, Ahmad Fadzli Vijayasingham, Naveen Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
description	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.
format	Article
author	Mohd Yusof, Nazri Ab Rahman, Jamalludin Zulkifly, Ahmad Hafiz Che Ahmad, Aminudin Khalid, Kamarul Ariffin Sulong, Ahmad Fadzli Vijayasingham, Naveen
author_facet	Mohd Yusof, Nazri Ab Rahman, Jamalludin Zulkifly, Ahmad Hafiz Che Ahmad, Aminudin Khalid, Kamarul Ariffin Sulong, Ahmad Fadzli Vijayasingham, Naveen
author_sort	Mohd Yusof, Nazri
title	Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
title_short	Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
title_full	Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
title_fullStr	Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
title_full_unstemmed	Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems
title_sort	predictors of major lower limb amputation among type ii diabetic patients admitted for diabetic foot problems
publisher	Singapore Medical Association
publishDate	2015
url	http://irep.iium.edu.my/45855/ http://irep.iium.edu.my/45855/ http://irep.iium.edu.my/45855/1/predictors_amputation_dfu_smj.pdf
first_indexed	2023-09-18T21:05:16Z
last_indexed	2023-09-18T21:05:16Z
_version_	1777410890946052096

Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

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