Retrospective evaluation of patients undergoing amputation surgery due to diabetic foot ulcers
Gamze Kucukosman, B. Koksal, Gizem Alkim Yilmaz
article (Uluslararası, Hakemli) | Yazar(lar): Gamze Kucukosman, B. Koksal, Gizem Alkim Yilmaz | Yıl: 2021 | Dergi/Kurum: ANNALS OF CLINICAL AND ANALYTICAL MEDICINE | İndeks: WOS.ESCI | DOI: 10.4328/acam.20578 | Anahtar Kelimeler: Diabetic Foot Ulcers, Amputation, Mortality — Özet: Aim: This study aims to determine the
Aim: This study aims to determine the characteristics of patients undergoing major lower extremity amputation (LEA) surgery due to diabetic foot ulcers.
Material and Methods: The study was conducted by scanning files between January 2016 and December 2018. Patients were divided into two groups as survivors and non-survivors over the course of a 30-day follow-up period.
Results: The files of 43 patients (25 men, 18 women; mean age: 67 +/- 11 years) were examined. Thirty-seven of those patients underwent below-the-knee amputation and 5 of the surgeries were urgent. It was observed that 56% of the patients were in the ASA 3 and 40% were in the ASA 4 risk group. There was no significant difference between the groups in terms of age, gender, amputation level, surgical procedure, number of comorbidities, ASA risk group, postoperative laboratory values, or follow-up location (p>0.05). However, preoperative albumin levels were found to be lower in patients who died (p=0.02). General anesthesia was applied for 3 of the patients who died (p=0.08). It was determined that 23 patients were hospitalized postoperatively in intensive care for close hemodynamic follow-up and none of them needed a ventilator. During the postoperative 30-day follow-up period, the mortality rate was 9.3% and mean time to death was determined as 15.4 +/- 20 days. Three of 4 patients died due to cardiac reasons while 1 patient died because of respiratory failure.
Discussion: Since there were no significant differences in our study except low albumin levels among non-survivors, we think that supporting diabetic patients with nutritional programs in the preoperative period with a multidisciplinary approach will affect the treatment process positively.