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Revista Cubana de Angiología y Cirugía Vascular
On-line version ISSN 1682-0037
Abstract
HERNANDEZ PEREZ, Mileidys and GARCIA SECO, Felicia Begoña. Indicators of amputation´s prognostic value in hospitalized patients with diabetic foot. Rev Cubana Angiol Cir Vasc [online]. 2020, vol.21, n.3 Epub Jan 22, 2021. ISSN 1682-0037.
Introduction:
Diabetes mellitus is the most important cause of non-traumatic amputations in the world. The prognosis of amputation risk is vital for the optimal treatment of patients hospitalized with diabetic foot disease.
Objective:
Characterize variables with amputation´s prognostic value in hospitalized patients diagnosed with diabetic foot disease.
Method:
A prospective longitudinal analytical study was conducted in the period from December 2015 to December 2017, with a sample consisting of 77 patients. The variables collected were age, sex, hemochemical results upon admission, co-morbidity, glycaemic control and amputations performed, the latter two during the hospital stay. Variables with significant association were included in a one-variety analysis (p < 0.05) in a multiple logistic regression model to evaluate their independent association. Positive, negative predictive values, and the degree of sensitivity and specificity were determined.
Results:
The prognosis indicators resulting from the analysis of the variables were the leuko-hematocrit index (p = 0.045), the level of albumin in blood (p = 0.004), the glycaemia at the mid-time of the stay (p = 0.045) and the glycaemia at the admission time (p = 0.039). The leuko-hematocrit index, in less than 6 patients at admission time, was related to a specificity of 92%; albumin, in less than 29.9 g/L, had a positive predictive value of 71%; glycaemia at admission time, higher than 21.5 mmol/L, showed a sensitivity of 75%;and glycaemia at mid-time of the stay, higher than 12.9 mmol/L, showed a sensitivity of 71%.
Conclusions:
The evolution to amputation of patients admitted due to diabetic foot is related to chronic inflammatory state, nutritional state and glycaemic control.
Keywords : Diabetes mellitus; chronic inflammation; neutrophil-lymphocyte index.