[Lower extremity amputations in diabetic patients: a case-control study].
OBJECTIVE
Lower extremity amputation is an increasing problem among diabetic patients and an important public health problem. The study purpose was to identify factors associated with lower extremity amputation.


METHODS
A matched case-control study was carried out among diabetic patients. Cases were selected in public health programs of the city of São Paulo, Brazil. One hundred and seventeen cases of diabetics with lower extremity amputation were compared to 234 controls of diabetics without amputation, matched by sex, age, and duration of disease. Sociodemographic variables, life habits (smoking and alcohol drinking), clinical aspects, and health education in diabetes were included. Univariate analyses and conditional logistic regression method were applied to data.


RESULTS
Data showed evidence of association for: smoking, last glucose test > or = 200 mg/dl, presence of peripheral somatic neuropathy and vibratory perception (tuning fork 128 Hz), and peripheral vascular disease. Diabetes treatment and attending nursing appointments for diabetes education were important factors for preventing lower extremity amputation in diabetic patients.


CONCLUSIONS
The knowledge of determinants and intervening factors for this condition will lead to cost reduction and better quality of care delivered in public health services.
Gamba
Mônica Antar
MA
Departamento de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. monica@denf.epm.br
Gotlieb
Sabina Léa Davidson
SL
Bergamaschi
Denise Pimentel
DP
Vianna
Lucila A C
LA
D000368:Aged; D000671:Amputation, Surgical; D001938:Brazil / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male