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Volume 24 |
October - December 2008 (Part-I) |
Number 5 |
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Volume 24 |
October - December 2008 (Part-I) |
Number 5 |
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Presentation and outcome of diabetic foot
at a tertiary care unitSyed Mansoor Ali1, Abdul Basit2, Asher Fawwad3,
Muhammad Yakoob Ahmedani4, Zahid Miyan5, Rayaz A Malik6ABSTRACT
Objectives: The prevalence of lower extremity amputation (LEA) is high in Pakistan, but the underlying risk factors remain to be defined. The purpose of this study was to define the presentation and risk factors determining outcome of diabetic foot ulceration leading to LEA in a tertiary care hospital in Karachi, Pakistan.
Methodology: We have characterized the presenting features, grade of foot ulceration and risk factors for ulceration and LEA in 214 diabetic patients presenting with foot ulceration between January 1997 and December 2003 to a tertiary care unit in Karachi, Pakistan.
Results: Seventeen (7.9%) patients had grade one, one hundred thirty three (62.1%) grade two and sixty four (29.9%) grade three ulceration. One hundred fifty five (72.43%) patients completely healed without LEA, while fifty nine (27.5%) patients underwent LEA. The risk of LEA was significantly associated with the grade of ulceration at presentation (p value=0.001), increasing age, and UT staging. Females presenting with foot ulceration had a higher BMI (P=0.0001), systolic (P=0.002) and diastolic (P=0.03) blood pressure and total cholesterol (P=0.03).
Conclusion: The outcome of ulceration was determined by the severity and grade of foot ulceration at presentation. Despite a significant proportion of patients having an underlying neuroischaemic aetiology for foot ulceration, the majority healed. There was significant gender difference for risk factors for neuropathic ulceration.
KEY WORDS: Diabetic foot, Lower Extremity Amputation (LEA).
Pak J Med Sci October - December 2008 (Part-I) Vol. 24 No. 5 651-656
How to cite this article:
Ali SM, Basit A, Fawwad A, Ahmedani MY, Miyan Z, Malik RA. Presentation and outcome of diabetic foot at a tertiary care unit. Pak J Med Sci 2008;24(5):651-56.
1. Syed Mansoor Ali, M.C.P.S.
Registrar,
2. Abdul Basit, F.R.C.P.
Professor of Medicine, Director, BIDE,
3. Asher Fawwad, M. Phil
Research Officer,
4. Mohammad Yakoob Ahmedani, FCPS.
Associate Professor of Medicine, Dept. of Medicine
5. Zahid Miyan, M.C.P.S.
Senior Registrar,
1-5: Baqai Medical University Hospital
Baqai Institute of Diabetology and Endocrinology,
Plot 1-2, II-B, Block 2, Nazimabad,
Karachi-74600, Pakistan.
6. Rayaz A Malik, PhD
Senior Lecturer and Consultant Physician
Cardiovascular Research Group,
Division of Cardiovascular and Endocrine Sciences
Core Technology Facility,
University of Manchester, UK
46 Grafton Street,
Manchester M13 9NT.Correspondence
Syed Mansoor Ali, M.C.P.S.
Registrar,
Medical Unit - IV,
Baqai Medical University Hospital,
Baqai Institute of Diabetology and Endocrinology,
Plot 1-2, II-B, Block 2,
Nazimabad,
Karachi-74600,
Pakistan.
Email: research@bideonline.com
* Received for Publication: March 17, 2008
* Revision Received: August 19, 2008
* Revision Accepted: August 21, 2008
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