Characteristics of patients with diabetic foot ulcer who underwent amputation or surgical debridement in Cumhuriyet University Hospital between 2007-2012, and effect of age and gender on diabetic foot ulcer related amputation or surgical debridement

Abstract

Objective: To describe the characteristics of the patients with diabetic foot ulcer who underwent surgical debridement or lower extremity amputation, and to examine the effect of gender and age on surgical debridement or amputation among patients with diabetes.

Methods: The medical records of all patients with diabetes who underwent surgical debridement or lower extremity amputation at the Plastic and Reconstructive Surgery or Orthopedics Clinics of Cumhuriyet University Hospital in Sivas (Turkey) during the period between January 2007 and March 2012 were reached by medical record screening. Of all cases (n=144), 122 underwent amputation, 22 surgical debridement. In order to estimate the effect size of age and gender on amputation or surgical debridement we used a control group (n=237) that included all diabetics identified in a population diabetes screening study conducted in Sivas in 2008. Multiple logistic regression analysis was used to estimate the adjusted odds ratios, and the model used included age and gender as independent variables.

Results: The mean number of patients with diabetic foot ulcer who underwent amputation or surgical debridement per year between 2008- 2011 was 27.4. Compared with female diabetics, age adjusted odds ratio for amputation or surgical debridement was 4.5 (95% CI:2.78-7.58) in male diabetics (p<0.01). Compared with diabetics aged 43-59 years, gender adjusted odds ratio for amputation or surgical debridement was 2.47 (95% CI:1.36-4.49) in diabetics aged 60-69 years 0.01 and 9.4 (95% CI: 5.11-17.36) in diabetics aged >=70 years (p<0.01).

Conclusions: This study let us determine the yearly burden in the hospital regarding amputation or surgical debridement related to diabetic foot ulcer, and supported the evidence that men are more likely to undergo diabetes related lower extremity amputation or surgical debridement. New studies are needed to understand the causes for this gender difference.