关键词: 糖尿病足, 截肢, 大截肢, 危险因素

Abstract: Objective To analyze risk factors for amputation using information on diabetic foot（DF） at community clinics for early detection of high-risk DF at the grassroots levels and early specialist treatment. develop cost-effective and extendible method for early detection and treatment, this study evaluated risk factors for diabetic foot （DF） amputation using easily accessed data from community medical centers. Methods A total of 403 DF patients admitted to First People′s Hospital of Kashi Prefecture between Jan 2018 and Jan 2021 were enrolled. They were divided into amputation and non-amputation group according to treatment and prognosis. Multivariate cox regression and K-M method were performed to analyze the factors influencing （major） amputation. Results The significant differences were showed on duration of diabetes mellitus （DM）, DF surgery history, blood glucose management, smoking, fever, Wagner grade, ankle brachial index （ABI）, hemoglobin （HB） between two groups （P<0.05）. The multivariate cox regression showed that DM>10 years （HR=2.439, 95%CI： 1.180-5.050, P=0.016）, DF surgery history （HR=2.403, 95%CI： 1.540-3.745, P<0.001）, uncontrolled blood glucose （HR=1.879, 95%CI： 1.259-2.898, P=0.002）, smoking （HR=1.644, 95%CI：1.085-2.487, P=0.019）, Wagner grade 3~5 （HR=1.980, 95%CI： 1.314-2.985）, P=0.001] and hypo-HB （HR=1.027, 95%CI： 1.011-1.044, P=0.001） were risk factors of amputation. Additionally, DM>18years （HR=2.544, 95%CI： 1.055-7.874, P=0.037） and DF surgery history （HR=2.525, 95%CI： 1.757-4.608, P=0.034） were risk factors of major amputation. Conclusion DF patients from community medical centers with long DM duration, DF surgery history, uncontrolled blood glucose, smoking, Wagner grade 3-5, hypo-HB and ABI<0.9 should be given more attention to prevent probable amputation.

Key words: diabetic foot, amputation, major amputation, risk factors