Cover Image

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...

Full description

Saved in:
Bibliographic Details
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/45855/1/predictors_amputation_dfu_smj.pdf
http://irep.iium.edu.my/45855/
http://smj.sma.org.sg/smjcurrent.html
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.iium.irep.45855
record_format dspace
spelling my.iium.irep.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 REM 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
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
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/45855/1/predictors_amputation_dfu_smj.pdf
http://irep.iium.edu.my/45855/
http://smj.sma.org.sg/smjcurrent.html
_version_ 1643612872309211136
score 13.211869

Similar Items