FACTORS ASSOCIATED WITH AMPUTATION IN DIABETIC FOOT ULCERS IN TERTIARY CARE CENTRE

Abstract

Background and Objectives: Diabetic foot ulcers, often leading to lower limb amputations, represent a frequent, complex, and debilitating complication of diabetes. Recognizing the critical necessity to pinpoint the variables that govern the usage of hospital facilities, this study seeks to facilitate preventive care monitoring and curtail the potentially preventable fatalities associated with this level of care. Method: We conducted a forward-looking observational study involving a cohort of 140 patients at the M.S. Ramaiah Medical College Hospital and Memorial Hospital from November 2020 to June 2022. Results: The present study encompassed 140 individuals predominantly between the ages of 50 and 60 with a noticeable male preponderance (7:1). A significant portion hailed from lower socioeconomic backgrounds and exhibited a PEDIS score gravitating towards grade 3. Additionally, a majority had a history of diabetes mellitus exceeding a decade. Patients presenting with wounds persisting for over a month were more likely to necessitate advanced levels of amputation. Remarkably, those who initially sought Ayurvedic treatments or home remedies for their diabetic foot ulcers faced a higher likelihood of undergoing extensive debridement or escalated levels of amputation once admitted to the hospital. Conclusion: This study elucidates that a multitude of factors including age, gender, socioeconomic standing, the longevity of diabetes mellitus, wound duration, smoking habits, and peripheral vascular diseases, along with specific biochemical and hematological parameters (namely, hemoglobin, ALP, HbA1c, and serum albumin levels) profoundly influence the progression and development of diabetic foot ulcers. These variables can be proficiently gauged using the PEDIS score, significantly impacting the surgical interventions required. Noteworthy is the apparent gap in research concerning the repercussions of utilizing home remedies and Ayurvedic treatments on the disease's progression, necessitating further exploration.

Keywords: Diabetic foot ulcer, Amputation, PEDIS score, Diabetes mellitus.