Department of surgery: CHUK, MHK and HPRC
Objective: To assess the predictive power of various parameters on the final outcome of ulcerated diabetic feet.
Methods and materials: This is a prospective, descriptive and analytical study carried out in the surgery departments of three reference hospitals (CHUK, HMK and HPRC) in Burundi from the 1st November 2014 to the 1st March 2016. All of the studied patients were grouped into three groups: the amputee group; the group of patients healed and the group of patients who died. The parameters studied were: socio-demographic and clinico-biological parameters.
Results: A total of 56 patients with diabetic foot were selected, low extremity amputation incidence was 60.7%; 17 cases were healed (30.3%) and 5 cases of death (8.9%). In assessing the influence of socio-demographic and clinico-biological characteristics on the outcome, we found that: more years of diabetes; diabetic arteriopathy , diabetic nephropathy ,severe consultation delay; An advanced stage of the wound according to the classification of the University of Texas were determined to be the most significant independent predictors of an unfavorable outcome(P<0.05).
Conclusion: In this prospective study, we conclude that the amputation rate was increasing and these following factors (more years of diabetes, a long delay in consultation, arterial disease, advanced stage of the wound according to the classification of the University of Texas and diabetic nephropathy are significantly predictive factors of low extremity amputation (p<0.05). Diabetics with these above risk factors are considered to be at greatest risk of amputation and should be followed closely by the health care system.
Key words: diabetic foot, amputation, prognosis and Texas classification.
Author: NIZIGIYIMANA Alexis, MD.