PREDICTING AMPUTATION RISK AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH DIABETIC FOOT ULCER USING PEDIS SCORES IN A TERTIARY HOSPITAL:

A PROSPECTIVE STUDY

Abstract

OBJECTIVES
The study aims to determine the demographic profile (age and gender) of patients who have diabetic foot ulcer (DFU), the presence of comorbidities such as obesity, hypertension, cardiovascular disease, liver disease and renal failure, and the correlation of PEDIS scoring in predicting amputation.

METHODOLOGY
 This was a prospective cohort study which included 50 patients who were admitted or seen at the outpatient department of CRMC from January to October 2021. The demographic data (age, gender and location) and comorbidities were obtained. Each patient had individual PEDIS scoring sheets. To assess for perfusion (P), an ankle brachial index (ABI) was done to determine if there was peripheral arterial disease (PAD) with or without critical limb ischemia. To describe the extent (E) of the wound, we graded them from 0 to +3 for skin intact, <1 cm2, 1–3 cm2, and >3 cm2, respectively. Depth (D) was evaluated by physical examination and foot x-rays. Infection (I) was assessed based on the presence of inflammation and secretions. Lastly, sensation (S) was evaluated using a 128-Hz tuning fork on the affected limb. Outcomes were documented, namely amputation, debridement and wound care.

RESULTS
There were no significance differences among subjects in terms of gender. However, age differences among patients were significant with a p value of 0.003 and was predictive of amputation among 41-60 age group with p value of 0.003. Hypertension was found to be a significant co-morbidity, with p value at 0.043. PEDIS scores among the participants were also significant with p value of <0.001 with 54% amputation rate for patients with PEDIS score >7.

CONCLUSION
Our findings indicate that patients with DFU aged 41 to 60 years, diagnosed with hypertension and PEDIS score >7 are likely to require amputation.