2010 Volume 120 Issue 7 Pages 1477-1482
Background: Foot ulcer is complication of diabetes which significantly deteriorates the quality of life of these patients, especially at times of lower extremity amputation. The objective of this study is to consider preventive measures to avoid amputation by analyzing the risk factors. Methods: Sixty patients with diabetic foot ulcers (49 male, 11 female) who were seen at the Dermatology Department of the St. Luke’s International Hospital from 2000–2007 were analyzed using retrospective cohort study design. Results: Both amputated and non-amputated diabetic patients with foot ulcers had long histories of diabetes, and most were accompanied with other complications. Especially among the amputated, histories of acute myocardial infarction and dialysis were significantly associated (p=0.02, p=0.05). HbA1c levels were high; serum albumin and hemoglobin were low in both groups at onset. Those who improved their serum albumin and hemoglobin levels by 0.2±1.2 g/dl (p=0.005) and 0.2±0.5 g/dl (p=0.003), respectively, were able to avoid amputation. Those with poor control of diabetes tended to undergo amputation. Complications of osteomyelitis and access to dermatology clinic both influenced the prognoses of these ulcers. Conclusion: The risk factors leading to amputation found in this study are measurable and reversible, and thus, can be helpful for early intervention.
