Factors influencing early and long-term results in patients with diabetic foot and peripheral arterial occlusive disease

Abstract

Introduction. The purpose of the study was to identify factors influencing early mortality and long-term results in patients with diabetic foot and peripheral arterial occlusive disease (PAOD).
Material and methods. A group of 120 consecutive patients with diabetic foot lesions and absent foot pulses was analysed. Follow-up period ranged from 3 to 6 years. Besides type of the undertaken treatment and its result, age and sex of the patient factors such as type and duration of diabetes, coexisting cardiovascular diseases, contralateral limb major amputation in the past, type of foot lesion, localisation of atherosclerotic lesions, pre-operative creatinine and haemoglobin levels and history of cigarette smoking were noted. The influence of the evaluated factors on early results and long-term survival was verified with discriminant analysis and Cox’s proportional hazard respectively.
Results. Older age, symptoms of critical limb ischemia, absence of revascularization, type 1 of diabetes and absent popliteal pulse were associated with early limb loss. Age of the patients however did not influence long-term limb salvage. Only four factors: major amputation (MA), coexisting cardiovascular diseases, contralateral limb MA in the past and absent popliteal pulse had statistically significant influence on in-hospital mortality. Neither failed revascularization nor older age of the patients did increase in-hospital mortality. With regard to long-term survival we found that advanced age and higher pre-operative creatinine levels were associated with worse result. Patients that underwent MA had poorer long-term survival than patients with salvaged limb but the difference was not statistically significant.