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Submitted: 25 July 2018 Modified: 25 July 2018
HERDIN Record #: R06-CLMMRH-18072514015175

Glycated Hemoglobin as a predictor of Arterial Occlusion Severity in Diabetic Foot infections managed with major amputation.

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Introduction: In this retrospective cohort study, we compared HbA1c levels of all diabetic patients with foot infections, and between those treated with major amputation (below-knee and above-knee) or conservatively.  

Methods: After ethics review board approval, a systematized chart review was performed. Three-hundred two feet from 264 consecutive patient referrals were enrolled in the study from January 1 to December 31, 2014. HbA1c result upon admission and routine histopathology of amputated limb posterior tibial artery were collected and tabulated in a spreadsheet, together with demographic and clinical data.  

Results: Majority of the patients were males (58.94%). The mean HbA1c of study participants was 9.81% (SD: 2.89%). Majority (78.15%) had uncontrolled blood sugar (HbA1c >7.0%). Forty-five percent underwent major amputation. The mean HbA1c of patients who did not undergo surgery was 7.89% (SD: 2.41%) while patients with major surgery had 11.20% (SD: 2.68%). The mean percentage for posterior tibial artery occlusion among amputated limbs was 31.46% n=135 (95% CI: 27.01% to 35.91%). On univariate analysis using linear regression analysis, Hba1c correlates with percentage occlusion in posterior tibial artery (F value=57.17, R square=0.1601, p value=0.000). Based on the linear regression analysis equation, the lowest HbA1c level that could predict a 90% occlusion of the posterior tibial artery is 14.11%.  

Conclusion: Patients with poor glucose control have higher incidence of undergoing major amputation. Among amputees, poor glucose control is associated with increased occlusion in the posterior tibial artery. 

Publication Type
Research Report
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Corazon Locsin Montelibano Memorial Regional Hospital Abstract Print Format

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