Epidemiology and Associated Factors of Lower-Limbs Amputation of Diabetic Foot Ulcer in Banmi Hospital, Lopburi Province

Abstract

Objectives: To evaluate the epidemiology and associated factors of amputation in patients with diabetic foot ulcers at Banmi hospital. Methods: Retrospective descriptive study of 233 patients with diabetic foot ulcers from January 2020 to December 2023. Generalized characteristic, disease related characteristic, laboratory data were collected. The patients were divided into two groups based on their amputation surgery. To explore causes, levels, result, length of stay, direct cost and medical coverage of diabetic-related lower limbs amputations, the data were analyzed by using descriptive statistics and multiple logistic regression with statistic significant level at 0.05. Results: The total number of diabetic foot ulcers during 2020-2023 was 233 patients. Among them, 97 (41.63%) were amputated. The Most patients (38.1%) over than 60 years old. The most common cause was due to ischemic infection foot ulcers (50.5%). Toe amputation (87.6%) was the most common level of amputation. Length of stay was 13 days with direct cost of 17,426.50 THB. Most of them were paid by universal coverage. Factors related to diabetic foot ulcers amputation were history of previous amputation (OR=9.17, 95%CI= 3.755-22.415), leukocytosis (OR=5.21, 95%CI= 2.252-12.053), anemia (OR=8.42, 95%CI= 1.914-37.056), high blood sugar level (OR=5.87, 95%CI= 1.893- 18.170), high HbA1c level (OR=3.05, 95%CI= 1.092-8.530) and osteomyelitis (OR=25.05, 95%CI= 5.925-105.89), significantly. Conclusion: Diabetic foot ulcers are a major public health problem and are the main cause of lower- limbs amputation in diabetes patients. Therefore, establishing guidelines, early detection of diabetic foot ulcer through multidisciplinary care and knowledge of risk factors for amputation can be helpful and decreased rate of lower-limbs amputation.