High Wagner’s grade, poor glycemic control, and anemia as risk factors for diabetic foot amputation (a cross-sectional study in Basrah city)

Aledresi, Khalid A.; Baqer, Firas Kadhim; Abdulmajeed, Inas Sabeeh

doi:10.33762/mjbu.2024.148492.1238

	High Wagner’s grade, poor glycemic control, and anemia as risk factors for diabetic foot amputation (a cross-sectional study in Basrah city)
The Medical Journal of Basrah University
Article 2, Volume 42, Issue 1, June 2024, Pages 9-16 PDF (461.06 K)
Document Type: Research Paper
DOI: 10.33762/mjbu.2024.148492.1238
Authors
Khalid A. Aledresi¹; Firas Kadhim Baqer^* ²; Inas Sabeeh Abdulmajeed³
¹Specialist Orthopaedic Surgeon, Head of Orthopedic Surgery Department, Al-Sader Teaching Hospital, Basrah, Iraq
²Al-Sader Teaching Hospital in Basrah
³Specialist Family medicine Doctor, Al-Sader Teaching Hospital, Basrah, Iraq.
Abstract
Background: Foot ulcers represent a major problem for diabetic patients and the managing doctors as well. Patients may need a major or minor lower limb amputation due to severe gangrene. Diabetic foot is regarded as the major cause of lower limb amputation in the world. The study aimed to identify the effects of high Wagner’s grade, poor glycemic control, and anemia as risk factors for amputation in diabetic foot patients. Materials and methods: A cross-sectional study was undertaken on 65 patients with diabetic foot ulcers at Al-Sader Teaching Hospital in Basrah. Ulcer grading was determined using Wagner’s classification system. The surgical outcome of the patients was studied in correlation with Hb level, HbA1C level, and Wagner’s grade to demonstrate the effect of these three variables on the outcome. Results: Of the 65 studied patients, 28(43.1%) required debridement, 32(49.2 %) had amputations and 5 (7.7%) patients had disarticulations. Thirty-eight patients (58.5%) had HbA1C levels of 8 and above, and 26 of them (68.4%) ended with amputation or disarticulation. Hemoglobin levels below 10 gm/dl were reported in 36 patients (55.4%), and 22 of them (61.1%) ended with amputation or disarticulation. There are Forty-five patients (69.2% of all) presented with Wagner 3,4, and 5 ulcers, and 31 (68.9%) of them ended with amputation or disarticulation, this indicates a statistically significant association between the high Wagner’s grade and the need for major limb amputation. Conclusion: the study showed that low hemoglobin level, poor blood sugar control, and high Wagner’s grade are all predictors of poor outcomes and an increased risk of amputation in our studied patients.
Keywords
Keywords: Wagner’s grade; diabetic foot; glycemic control; anemia

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