Determinant related to amputation and mortality among patients with diabetic foot at Yaoundé central Hospital

Abstract

Background: Diabetic foot complications (DFC) are a significant cause of morbidity and mortality worldwide, often leading to amputations and death. This study aimed to identify the determinants of amputation and mortality outcomes among diabetic foot patients at the Yaoundé Central Hospital in Cameroon.

Methods: This was a retrospective descriptive study of medical records for 329 patients with diabetic foot admitted between January 2019 and December 2021. We collected data on patient demographics, comorbidities, laboratory findings, and clinical presentation using the Wagner classification. The primary outcomes were lower-limb amputation and mortality. We performed a multivariate logistic regression to identify factors associated with amputation and mortality related to diabetic foot outcomes.

Results: The mean age of the patients was 57.9 years, with 66% having type 2 diabetes. The most common comorbidities were heart failure (38%) and hypertension (33.7%). The study found a high rate of poor outcomes, with 75 patients (22.8%) undergoing amputation and 77 patients (23.4%) dying. Multivariate analysis revealed that dyslipidemia (adjusted odds ratio [aOR]: 2.942) and a Wagner classification ≥ 4 (aOR: 0.053) were significant, independent predictors of adverse outcomes.

Conclusion: The presence of dyslipidemia and a high-grade Wagner classification are critical determinants of poor outcomes in diabetic foot patients at Yaounde central hospital. These findings underscore the urgent need for enhanced screening, aggressive lipid management, and timely, specialized care for severe diabetic foot disease to reduce the high rates of amputation and mortality.