Abstract
Aims: Although literature is scarce, it is a common belief that patients with lower social background are more prone to diabetic complications. The purpose of this study was to identify local, systemic, and psychosocial risk factors that can lead to severe foot infections and subsequent amputations. Methods: This study was set up as a case-control study. We enrolled 112 persons with diabetes, in an approximately 1:1 case to control ratio. Cases were defined as patients admitted to the hospital with a severe foot infection, possibly necessitating a lower extremity amputation; controls were patients admitted for nonemergent medical or surgical cause. Study participants received a physical examination and interview to evaluate exposure variables, including demographic data, general medical, surgical, diabetes, and diabetes-related complication history. Socioeconomic status was quantified with the Duncan socioeconomic impact and Siegel prestige score. The patient's knowledge of foot care was evaluated as well. The risks for severe foot infection of social, economical, and physical risk factors were compared in a stepwise logistic regression analysis. Results: The following variables were significant factors for severe foot infection: history of previous amputation [odds ratio (OR)=19.9, P=.01], peripheral vascular disease (OR=5.5, P=.007), and peripheral neuropathy, as measured with vibratory perception threshold (OR 3.4, P=.044). Social and economic factors were not significant in this model. Conclusions: These data suggest that physical risk factors are important in foot infection and that the additional risk of socioeconomic status or knowledge of foot care is limited in this population.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 107-112 |
| Number of pages | 6 |
| Journal | Journal of Diabetes and its Complications |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 2005 |
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Keywords
- Amputation
- Diabetes
- Infection
- Psychosocial
- Risk
ASJC Scopus subject areas
- Endocrinology
- Endocrinology, Diabetes and Metabolism
Cite this
Diabetic lower extremity infection : Influence of physical, psychological, and social factors. / Peters, Edgar J G; Lavery, Lawrence A.; Armstrong, David G.
In: Journal of Diabetes and its Complications, Vol. 19, No. 2, 03.2005, p. 107-112.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diabetic lower extremity infection
T2 - Influence of physical, psychological, and social factors
AU - Peters, Edgar J G
AU - Lavery, Lawrence A.
AU - Armstrong, David G.
PY - 2005/3
Y1 - 2005/3
N2 - Aims: Although literature is scarce, it is a common belief that patients with lower social background are more prone to diabetic complications. The purpose of this study was to identify local, systemic, and psychosocial risk factors that can lead to severe foot infections and subsequent amputations. Methods: This study was set up as a case-control study. We enrolled 112 persons with diabetes, in an approximately 1:1 case to control ratio. Cases were defined as patients admitted to the hospital with a severe foot infection, possibly necessitating a lower extremity amputation; controls were patients admitted for nonemergent medical or surgical cause. Study participants received a physical examination and interview to evaluate exposure variables, including demographic data, general medical, surgical, diabetes, and diabetes-related complication history. Socioeconomic status was quantified with the Duncan socioeconomic impact and Siegel prestige score. The patient's knowledge of foot care was evaluated as well. The risks for severe foot infection of social, economical, and physical risk factors were compared in a stepwise logistic regression analysis. Results: The following variables were significant factors for severe foot infection: history of previous amputation [odds ratio (OR)=19.9, P=.01], peripheral vascular disease (OR=5.5, P=.007), and peripheral neuropathy, as measured with vibratory perception threshold (OR 3.4, P=.044). Social and economic factors were not significant in this model. Conclusions: These data suggest that physical risk factors are important in foot infection and that the additional risk of socioeconomic status or knowledge of foot care is limited in this population.
AB - Aims: Although literature is scarce, it is a common belief that patients with lower social background are more prone to diabetic complications. The purpose of this study was to identify local, systemic, and psychosocial risk factors that can lead to severe foot infections and subsequent amputations. Methods: This study was set up as a case-control study. We enrolled 112 persons with diabetes, in an approximately 1:1 case to control ratio. Cases were defined as patients admitted to the hospital with a severe foot infection, possibly necessitating a lower extremity amputation; controls were patients admitted for nonemergent medical or surgical cause. Study participants received a physical examination and interview to evaluate exposure variables, including demographic data, general medical, surgical, diabetes, and diabetes-related complication history. Socioeconomic status was quantified with the Duncan socioeconomic impact and Siegel prestige score. The patient's knowledge of foot care was evaluated as well. The risks for severe foot infection of social, economical, and physical risk factors were compared in a stepwise logistic regression analysis. Results: The following variables were significant factors for severe foot infection: history of previous amputation [odds ratio (OR)=19.9, P=.01], peripheral vascular disease (OR=5.5, P=.007), and peripheral neuropathy, as measured with vibratory perception threshold (OR 3.4, P=.044). Social and economic factors were not significant in this model. Conclusions: These data suggest that physical risk factors are important in foot infection and that the additional risk of socioeconomic status or knowledge of foot care is limited in this population.
KW - Amputation
KW - Diabetes
KW - Infection
KW - Psychosocial
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=14644423926&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=14644423926&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2004.06.002
DO - 10.1016/j.jdiacomp.2004.06.002
M3 - Article
C2 - 15745841
AN - SCOPUS:14644423926
VL - 19
SP - 107
EP - 112
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
SN - 1056-8727
IS - 2
ER -