Nutritional and Inflammatory Markers as Predictors of Major Amputation in Patients with Diabetic Foot Infections Diyabetik Ayak Enfeksiyonu Olan Hastalarda Majör Amputasyon Öngörücüsü Nutrisyonel ve Enflamatuvar Belirteçler
Medical Journal of Bakirkoy, cilt.21, sa.4, ss.380-385, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/bmj.galenos.2025.2025.7-3
- Dergi Adı: Medical Journal of Bakirkoy
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.380-385
- Anahtar Kelimeler: Diabetic foot infection, major amputation, prognostic nutritional index, inflammation, albumin
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Diabetic foot infections (DFIs) are serious complications of diabetes mellitus and a major cause of lower extremity amputations. Identifying predictive factors for major amputation can guide treatment and improve patient outcomes. Methods: In this retrospective cross-sectional study, 77 patients with DFIs who were treated between December 2022 and July 2024 were evaluated. Clinical and laboratory data were collected, including inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), leukocyte count], hematologic parameters, and nutritional indices [albumin, hemoglobin, prognostic nutritional index (PNI)]. Amputations were classified as major or minor based on anatomical level. Statistical analyses were conducted to identify predictors of major amputation. Results: Major amputations were performed in 25.9% of patients. Compared with patients without major amputation, those who underwent major amputation had significantly higher leukocyte, neutrophil, and platelet counts, CRP, and ESR levels and lower hemoglobin, albumin, and PNI scores (all p<0.05). No significant differences were observed in neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, or systemic immune-inflammation index values between the groups. PNI was strongly associated with the need for major amputation. Conclusion: Nutritional status, especially PNI and serum albumin, and inflammatory markers are valuable predictors of major amputation in patients with DFIs. Early assessments of nutritional and inflammatory status may reduce the risk of amputation and improve prognosis.