Risk factors of treatment failure in diabetic foot ulcer patients

Abstract

Background Some diabetic feet heal without complication, but others undergo amputation dueto progressive wounds. This study investigates the risk factors for amputation of diabetic feet.Methods A total of 55 patients who visited our institution from 2008 to 2012 were includedin the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, andpoor nutrition were excluded from the study group, and the wound states were unified. Thepatients were categorized into a treatment success group (n=47) and a treatment failuregroup (n=8), and their hemoglobin A1C (HgA1C), C-reactive protein (CRP), white blood cellcount (WBC), and serum creatinine levels were analyzed.Results The initial CRP, WBC, and serum creatinine levels in the treatment failure group weresignificantly higher than that of the treatment success group, and the initial HgA1C level wassignificantly higher in the treatment success group. The CRP and WBC levels of both groupschanged significantly as time passed, but their serum creatinine levels did not.Conclusions The initial CRP, WBC, and serum creatinine levels were considered to be riskfactors for amputation. Among them, the serum creatinine level was found to be the mostimportant predictive risk factor. Because serum creatinine represents the renal function,thorough care is needed for the feet of diabetic patients with renal impairment.