Factors Affecting Amputations in Patients with Diabetic Foot Ulcer Referring To the Emergency Units

Giriş: Diyabetik ayak nontravmatik alt ekstremite ampütasyonlarının en yaygın nedenidir. Bu çalışmanın amacı acil servise başvuran diyabetik ayak hastalarının klinik özelliklerini ve ampütasyonu etkileyen faktörleri incelemektir. Yöntemler: Bu çalışma Haziran 2010-Ekim2016 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Acil Servisi'ne diyabetik ayak ülseri nedeni ile başvuran 58 hasta retrospektif olarak hasta dosyaları incelenerek yapıldı. Bulgular: Bu çalışmada toplamda 58 olgunun31(%53,4)'i erkek, 27(%46,6)'i kadındı. Yaş ortalaması 61.43±11.584 idi. Olguların 34(%58,6)'üne ekstremite ampütasyonu yapılmadı, 24(%41,4)'üne yapıldı. Hastalık süresi, koroner arter hastalığı, hastaneye yatış süresi, osteomiyelit varlığı ekstremite ampütasyonunu etkileyen faktörlerdi. Laboratuvar bulgularından albümin, hemoglobin, lökosit, nötrofil, nötrofil/lenfosit oranı hemoglobin A1c, eritrosit sedimetasyon hızı yüksekliği ekstremite ampütasyonunu etkileyen faktörlerdi. WagnerMeggitt sınıflamasında derece 4, University of Texas sınıflamasında evre D ve derece 3 ampütasyonu etkileyen faktörlerdi (p

Acil Servise Başvuran Diyabetik Ayak Hastalarında Amputasyonu Etkileyen Faktörler

Objective: Diabetic foot is the most common cause of lower extremity amputations. The aim of the present study was to investigate the clinical characteristics of and factors affecting amputation in patients with diabetic foot ulcer referring to the emergency units. Methods: The present study was performed based on retrospective review of medical files of 58 patients who were referred to the Emergency Unit of Dicle University, Faculty of Medicine between June 2010 and October 2016 due to diabetic foot ulcer. Results: Of 58 patients included in this study, 31 (53.4%) were men and 27 (46.6%) were women. The mean age was 61.43±11.584 (range: 41 to 85) years. Extremity amputation was not performed in 34 patients (58.6%), while 24 (41.4%) underwent an amputation. Factors affecting extremity amputation were found to be disease duration, presence of coronary artery disease, duration of hospital stay, and presence of osteomyelitis. Among laboratory findings, factors affecting extremity amputation were albumin, hemoglobin, leukocytes, neutrophil, neutrophil/lymphocyte ratio, hemoglobin A1c, and elevated erythrocyte sedimentation rate. The Wagner-Meggitt Classification of Grade 4, University of Texas Classification of stage D and Grade 3 also had significant effects on amputation. (p<0.05) Conclusion: Our study results suggest that together with classification systems, comorbidities, albumin levels, hemoglobin A1c levels, sedimentation rate, and complete blood count results play a key role in predicting the amputation requirement in patients with diabetic foot ulcers referring to the emergency units

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