Predictive Factors for Lower Extremity Amputation in Diabetic Foot Patients: A Prospective Observational Study

Dr. Kothapalli Anudeep, Dr. Madala Samba Siva Rao, Dr. K Sai Sanath

Abstract: Background: Diabetic foot ulcers (DFUs) are a frequent and severe complication of diabetes mellitus, often resulting in lower extremity amputation (LEA). Early identification of risk factors can mitigate this outcome. Objectives: To evaluate the predictive significance of clinical, laboratory, and microbial factors associated with LEA in patients with DFUs. Methods: A prospective observational study was conducted at ASRAM Medical College, Eluru, over 24 months (July 2022?June 2024). A total of 150 diabetic foot patients were enrolled and analyzed based on clinical history, examination, ABI, lab values (Hb, WBC, CRP, LDL), and microbiological culture. Results: Out of 150 patients, 64 (42.6%) underwent amputation. Factors significantly associated with LEA included presence of gangrene (100%), absent distal pulses (100%), ABI <0.3 (96.8%), osteomyelitis (100%), Hb <10 g/dL (62.5%), elevated WBC (>10,000/mm?), CRP >10 mg/L (93.7%), LDL >100 mg/dL (68.7%), and antibiotic-resistant infections (28%). Conclusion: LEA in diabetic foot is strongly associated with vascular insufficiency, infection, anemia, and inflammatory markers. Early identification of these risk factors is crucial in preventing progression to amputation.

Keywords: Gangrene, vascular insufficiency, osteomyelitis, inflammatory markers, antibiotic resistance