Clinical Characteristics Of Patients With Type 2 Diabetic Foot Amputation

Objective: To analyze the clinical characteristics of type 2 diabetic foot patients with amputation.Methods: The clinical data of 201 patients with type 2 diabetic foot who underwent amputation in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2022 were retrospectively analyzed.According to the level of amputation,they were divided into a major amputation group and a minor amputation group,and according to age,they were divided into a young and middle-aged group and an elderly group.Univariate and multivariate logistic regression analysis were performed for the major and minor amputation groups,and univariate analysis was performed for the young and middle-aged group and the elderly group.Results: A total of 201 patients with type 2 diabetic foot amputation were enrolled,with an average age of 62.76±10.31 years,including 141 males(70.1%)and 60 females(29.9%).The patients aged 50-59 years had the highest number of amputee patients.There were 68 major amputations(33.8%)and133 minor amputations(66.2%).Wagner grade of ulcer was less than 3 in 103 cases(51.2%),grade 4 in 84 cases(41.8%),and grade 5 in 14 cases(7.0%).There were significant differences in Wagner grade of ulcer,positive rate of ulcer bacterial culture,prevalence of lower extremity arterial disease,coronary heart disease,hemoglobin,plasma D-dimer and albumin between the small and large amputation groups(P<0.05).Multivariate logistic regression analysis showed that hemoglobin was a protective factor for major amputation,while coronary heart disease was a risk factor.There were significant differences in the course of diabetes,lower extremity arterial disease,hypertension,coronary heart disease,smoking history,drinking history,glycosylated hemoglobin and triglyceride between the young and middle-aged group and the elderly group(P<0.05).Conclusions: The majority of patients with type 2 diabetic foot amputation are male,and the rate of major amputation in males is significantly higher than that in females.The incidence of lower extremity arterial stenosis and arterial occlusive disease is higher in the major amputation group,and lower extremity revascularization is more likely to occur in the major amputation group.Hemoglobin is a protective factor,and coronary heart disease is a risk factor.The Wagner grade and positive rate of bacterial culture were higher in the minor amputation group.The arteries of the lower extremities were mostly free of disease or mild sclerosis.The elderly patients with type 2 diabetes mellitus who underwent amputation have the characteristics of longer duration of diabetes,higher prevalence of hypertension,coronary heart disease,arterial occlusive disease,and higher rate of lower extremity revascularization.However,the levels of glycosylated hemoglobin,2h blood glucose and triglyceride were higher in the young and middle-aged patients with type 2 diabetes and amputation,and they had bad habits such as smoking and drinking.