What are the risk factors for losing your leg from a foot ulcer?

This study investigated the risk of foot amputation (removal of the foot or part of it) in patients with diabetic foot ulcers to see what factors increase this risk. They found that being male, smoking, and having a history of previous foot ulcers all increased the risk of amputation.  

Foot ulcers are a common complication of diabetes and the leading cause of hospitalization in diabetic patients. Severe foot ulcers can result in the amputation of the affected toe, foot, or leg. Amputation has a huge impact on patients’ quality of life and increases their risk of further amputations or death. It is not yet known which patients are at greatest risk of amputation and if there are any risk factors that can be modified to reduce this risk.

The results of 21 studies involving 6,505 patients were analyzed for this study. All studies involved patients with diabetic foot ulcers. They were analyzed to determine which factors increased the risk of lower extremity amputation (removal of a leg, foot, or toe) in these patients.

2006 patients required amputation. The main factors associated with an increased risk of amputation were male sex, smoking, previous history of foot ulcers, osteomyelitis (bone infection) and gangrene (infection causing tissue death). 

Men with diabetic foot ulcers were 30% more likely to require amputation than women. Patients with a history of smoking were 19% more likely to need an amputation. Patients with a history of previous foot ulcers were 2.48 times more likely to require an amputation. Those with osteomyelitis were 3.7 times more likely to need amputation, while those with gangrene were at 10.9 times greater risk of amputation.

Age, type of diabetes and high blood pressure had no effect on the risk of amputation.

This study showed that men who smoke and have foot ulcers that have progressed to infecting the bone or causing tissue death are much more likely to require amputation. 

This study is based on medical records. Information might have been missing. More study is required.

Early treatment of foot ulcers is important to reduce the risk of amputation. Speak to your physician immediately if you have any concerns about foot ulcers.