Causal Factors for Amputation in Patients Diagnosed with Diabetic Foot

Abstract

Introduction: Diabetic foot is a complication of diabetes mellitus and a major risk factor for amputation due to peripheral vascular disease.

Objective: To identify the causal factors associated with amputation in patients with diabetic foot.

Methods: A retrospective observational analytical case-control study was conducted in the Southern Zone of the province of Ciego de Ávila between January 2014 and December 2024. Fisher’s exact test and continuity correction were used to identify associations between risk factors for amputation. The confidence interval (CI) for the odds ratio (OR) was determined with a 95% confidence level.

Results: General risk factors showed a significant association: sex (p = 0.000) and male gender (OR = 1.5), type 1 diabetes (OR = 2.8), and the absence of peripheral pulses (OR = 4.8). All vascular patterns, based on the clinical presentation of the patients studied, were associated with the risk of amputation (p = 0.000). In the etiological diagnosis, ischemic diabetic foot (OR = 1.6) and mixed diabetic foot (OR = 30.3) increased the risk of amputation. The Wagner Grade II classification was found to be a protective factor in the case group; Grades III and IV were directly proportional to the frequency of amputation (p = 0.000 and OR = 12 and 41.4, respectively). The Texas classification (B-II, B-III, C-II, D-II, D-III) showed an association with amputation.

Conclusions: The identified causal factors contribute to our understanding of the risk of amputation in patients with diabetic foot in the studied health region.