Clinical research on predicting the outcome of amputation of diabetic arterial occlusion by WIFi classification after endovascular therapy

doi:10.3877/cma.j.issn.1674-0793.2020.01.010

Abstract

Abstract:

Objective

To evaluate the clinical significance of wound-ischemia-foot infection (WIFi) classification in predicting the occurrence of amputation after endovascular therapy in patients with diabetic arterial occlusion (DAO).

Methods

Eighty patients with DAO in Shandong Provincial Hospital, Jinan Municiple Hospital of Traditional Chinese Medicine and Zhanhua District People’s Hospital from July 2015 to July 2018 were divided into two groups according to be amputated or not. Forty-four patients were included in the amputation group while 36 patients in the non-amputation group. The clinical data and WIFi grading after endovascular therapy were analyzed retrospectively. The independent risk factors of amputation in DAO patients were analyzed by Logistic regression.

Results

There were no significant differences in sex (χ²=1.678, P=0.195), age (t=1.697, P=0.094), glycosylated hemoglobin (t=-0.419, P=0.677), body mass index (t=-0.236, P=0.814), fasting blood glucose (t=-0.640, P=0.524), duration of diabetes mellitus (t=-0.732, P=0.466) and history of hypertension (χ²=1.347, P=0.466) between the two groups. The number of high-grade patients with woud (W), ischemia (I) and foot infection (Fi) in the amputation group was significantly higher than that in the non-amputation group (χ²=27.963, 30.901, 19.140, all P<0.001). Logistic regression showed that W, I and Fi were independent risk factors for amputation in patients with DAO after intracavitary treatment (95% CI: 0.022-0.309, 0.020-0.319, 0.073-0.900, P<0.001, <0.001, 0.034).

Conclusions

The degree of lower limb ischemia, wound or gangrene of lower limb and foot infection are independent risk factors for amputation after intracavitary treatment of DAO. WIFi grade can effectively predict amputation after endovascular therapy of DAO.

Key words: Diabetes mellitus, Arterial occlusive diseases, Amputation, Risk factors, WIFi classification

Jianguo Wang, Xianghong Meng, Yan Sun, Yutao Wang. Clinical research on predicting the outcome of amputation of diabetic arterial occlusion by WIFi classification after endovascular therapy[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(01): 35-38.

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References 17

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组别	例数	年龄(岁)	性别(男/女,例)	BMI(kg/m²)	HbA1c(%)	入院空腹血糖(mmol/L)	高血压病史(年)	DAO病程(年)
未截肢组	36	58.89±11.75	9/27	26.69±3.53	9.49±2.11	10.11±1.71	11	17.17±9.43
截肢组	44	54.84±9.59	17/27	26.89±4.04	9.69±2.03	10.35±1.62	19	18.71±9.27
统计值		1.697	1.678^a	-0.236	-0.419	-0.640	1.347^a	-0.732
P值		0.094	0.195	0.814	0.677	0.524	0.246	0.466

组别	例数	年龄(岁)	性别(男/女,例)	BMI(kg/m²)	HbA1c(%)	入院空腹血糖(mmol/L)	高血压病史(年)	DAO病程(年)
未截肢组	36	58.89±11.75	9/27	26.69±3.53	9.49±2.11	10.11±1.71	11	17.17±9.43
截肢组	44	54.84±9.59	17/27	26.89±4.04	9.69±2.03	10.35±1.62	19	18.71±9.27
统计值		1.697	1.678^a	-0.236	-0.419	-0.640	1.347^a	-0.732
P值		0.094	0.195	0.814	0.677	0.524	0.246	0.466

变量	回归系数	标准误	Wald值	P值	OR值	95% CI
W分级	-2.504	0.678	13.633	<0.001	0.082	0.022~0.309
I分级	-2.524	0.704	12.851	<0.001	0.080	0.020~0.319
Fi分级	-1.359	0.640	4.511	0.034	0.257	0.073~0.900

变量	回归系数	标准误	Wald值	P值	OR值	95% CI
W分级	-2.504	0.678	13.633	<0.001	0.082	0.022~0.309
I分级	-2.524	0.704	12.851	<0.001	0.080	0.020~0.319
Fi分级	-1.359	0.640	4.511	0.034	0.257	0.073~0.900

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