Home 2016 - Volume 16 (2) PROGNOSTIC FACTORS OF MAJOR AMPUTATION AMONG HOSPITALIZED DIABETIC FOOT PATIENTS IN A TERTIARY TEACHING HOSPITAL, MALAYSIA
PROGNOSTIC FACTORS OF MAJOR AMPUTATION AMONG HOSPITALIZED DIABETIC FOOT PATIENTS IN A TERTIARY TEACHING HOSPITAL, MALAYSIA PDF Print E-mail
Sunday, 28 February 2016 16:45

Nor Hakimah Ab Rahman1,AnizaAbd. Aziz2, Wan Mohd Zahiruddin W Mohammad1 , Abdul Nawfar Sadagatullah1,Wisam Abdul Kadder Yassin2 , Zawawi Nordin2

1School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia , 2Faculty of Medicine, Medical Campus, Universiti Sultan ZainalAbidin, 20400, Kuala Terengganu, Malaysia

ABSTRACT

Diabetic foot ulcer is a major health care problem leading to hospitalization, morbidity, amputation and mortality in diabetic patients. The aim of this study is to determine the amputation-free probability and prognostic factors of major amputation among hospitalized diabetic foot patients in a tertiary teaching hospital in Malaysia. A retrospective record review study was conducted among 231 hospitalized diabetic foot patients in Hospital Universiti Sains Malaysia from 1st January 2007 until 31st December 2011 followed by 1 year follow up. Patients medical records were retrieved and reviewed. Socio-demographic, clinical characteristics and amputation endpoint status were recorded. The duration of amputation-free time was measured from the date of being diagnosed as diabetic foot until the date of amputation.Simple and Multiple Cox regression were performed to determine the prognostic factors of major amputation. The patients age ranged from 21 to 83, with mean (SD) was 56.9 (10.4) years. Majority were male (51.5%) and Malays (95.7%). The overall proportion of amputation due to diabetic foot was 88.7% which comprised of minor (76.6%) and major amputation (13.7%). The adjusted prognostic factors that were found to be significantly influence the risk of having major amputation among hospitalized diabetic foot patients in HUSM were age at diagnosed of DFU (Adjusted HR: 1.05, 95% CI: 1.00, 1.09, P=0.033), gender (Adjusted HR: 0.21, 95% CI: 0.07,0.66, P=0.007), duration of DM (Adjusted HR: 2.76, 95% CI: 1.25, 6.12, P=0.012), smoking status(Adjusted HR: 4.19, 95% CI: 1.12, 15.65, P=0.033) and status of DFU (Adjusted HR: 2.55, 95% CI: 1.10, 6.07, P=0.029). Older diabetic patients, female, having diabetes more than 10 years, smoker and recurrent DFU were at higher risk of major amputation.

Keywords: diabetic foot ulcer, amputation-free time, major amputation, prognostic factors

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Last Updated on Sunday, 28 February 2016 16:48
 

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ISSN No : 1675-0306
e-ISSN No : 2590-3829

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