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Journal of Diabetes Research
Volume 2016, Article ID 8931508, 8 pages
Research Article

Risk Factors for Foot Amputation in Patients Hospitalized for Diabetic Foot Infection

1Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil
2University of Sorocaba, Rodovia Raposo Tavares, Km 92,5, 18023-000 Sorocaba, SP, Brazil
3Universidade de Brasília, Brasília, DF, Brazil

Received 28 July 2015; Revised 4 January 2016; Accepted 27 January 2016

Academic Editor: Edward Jude

Copyright © 2016 Maria Teresa Verrone Quilici et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study was to identify and quantify risk factors for amputation in diabetic patients hospitalized for foot infections. This cross-sectional study comprised 100 patients with diabetic infectious complications in the lower limbs. The variables investigated were related to diabetes, infection, and treatment compliance. Multiple Cox regression analysis was performed to identify the variables independently associated with the outcome of amputation. The most prevalent chronic complications were neuropathy and hypertension. Most patients presented with a neuroischemic foot (86%). The Morisky test showed that 72% were not compliant with diabetes treatment. Regarding patient outcome, 61% progressed to amputation, 14% to debridement, and 9% to revascularization. The results showed a 42% higher risk for progression to amputation in patients with previous use of antimicrobials. Also, the amputation risk was 26% higher for those less compliant with diabetes treatment. An increase of one point in the Wagner ulcer classification criteria corresponded to a 65% increase in the risk of amputation. Undergoing conservative, nonsurgical procedures prior to admission provided a 63% reduction in the risk of amputation. Knowledge of these factors is critical to enable multidisciplinary teams to develop treatment plans for these patients so as to prevent the need for amputation.