Bo Yang,1,* Xuwen Zha,2,* Yunling Ding1 

1Department of Burn & Plastic Surgery, The First People’s Hospital of Hefei, Binhu Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230000, People’s Republic of China; 2Department of Rheumatology and Immunology, The First People’s Hospital of Hefei, Binhu Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yunling Ding, Department of Burn & Plastic Surgery, The First People’s Hospital of Hefei, Binhu Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230000, People’s Republic of China, Email yunlinding@163.com

Objective: Diabetic foot ulcer (DFU) and related amputation significantly contribute to morbidity rates. The objective of this study was to assess the risk factors correlated with amputation in Chinese patients with DFU.
Methods: A prospective study was implemented on DFU patients at Third Affiliated Hospital of Anhui Medical University from February 2016 to May 2024. Patients were categorized into two groups based on whether they underwent amputation: the amputation group (n = 33) and the non-amputation group (n = 29). A comparative analysis was conducted between two groups, focusing on demographic data, disease characteristics, and laboratory indicators. Binary and multivariate logistic regressions were employed to evaluate the risk factors associated with amputation. Receiver Operating Characteristic curve analysis was used to assess the risk factors in predicting amputation in patients with DFU.
Results: The incidence of history of amputation, duration of diabetes in the amputation group were significantly increased compared to the non-amputation group (P < 0.05). On the contrary, the red blood cell count, hemoglobin level, and hematocrit in the amputation group were significantly lower compared to the non-amputation group (P < 0.05). Moreover, in the bi-variable logistic regression analysis, the duration of diabetes, duration of DFU, history of amputation, and hemoglobin levels were significantly associated with amputation (P < 0.05). After controlling potential confounding factors in multiple logistic regression analysis, duration of DFU was identified as a determining factor for amputation (P < 0.05). Additionally, the values for the area under curve (AUC) in relation to the duration of diabetes, duration of DFU, history of amputation, and a combined panel in predicting the occurrence of amputation in patients with DFU were 0.890, 0.868, 0.730, and 0.916, respectively.
Conclusion: Our findings indicate that duration of DFU is an independent risk factor for amputation in patients with DFU.

Keywords: amputation, diabetic foot ulcer, risk factors, diabetes mellitus