Central Malaysia's Silent Epidemic: Predictive Insights into Diabetic Foot Amputation

Diabetic foot infection (DFI) is a prevalent and severe complication of diabetes mellitus, often leading to lower extremity amputations. This study uses electronic medical records from a tertiary care hospital in Central Malaysia to investigate the predictive factors associated with the type of amputation (major vs minor) in patients with DFI, once the amputation is decided. Methods: This retrospective cohort study analysed data from 434 patients admitted with DFI between January 2010 and December 2019. The information extracted from medical records included demographics, clinical characteristics (inflammatory markers and clinical complications), and amputation details. Binary logistic regression was performed to identify significant major vs minor predictors of amputation. Results: Most amputations were minor (70.7%), with Wagner grade 4 being the most common presentation. Elderly patients and higher Wagner scores are predictors of major (vs minor) amputation. Conclusion: This study underscores the critical role of age and Wagner classification for risk of major (vs minor) amputation among DFI patients. Identifying these underlying risk factors is crucial for developing targeted interventions, improving patient outcomes, and enhancing the quality of care for DFI patients.