Abstract

DAMAS-CASANI, Vivian Adriana; YOVERA-ALDANA, Marlon  and  SECLEN SANTISTEBAN, Segundo. Classification of foot at risk of ulceration following the IWGDF classification and associated factors in type 2 diabetic patients in a Peruvian hospital. Rev Med Hered [online]. 2017, vol.28, n.1, pp.5-12. ISSN 1018-130X.  http://dx.doi.org/10.20453/rmh.v28i1.3067.

Objectives: To determine the frequency of foot at risk of ulceration following the international working group diabetic foot classification and associated factors in type 2 diabetic patients in a general Peruvian hospital in Lima. Methods: cross sectional study using secondary data. We reviewed 382 medical charts of type 2 diabetic patients gathered by the endocrinology service of Hospital Maria Auxiliadora from January 2013 to December 2015. Each medical chart had demographic data, and physical examination information that included monofilament, diapason 128Hz and peripheral pulse evaluations. The IWGDF was used: grade 0 means no peripheral neuropathy (PN), grade 1 means PN, grade 2 means peripheral arterial disease (PAD) and/or foot deformity and grade 3 means history of foot ulcer. Descriptive and inferential statistics were used. Results: 73.9% were females; mean age was 60.3 years; 61% had Hba1c>7% and 55% had more than 5 years of illness. Based on IWGDF, 22% had grade 0, 8% grade 1, 64% grade 2 and 6.5% grade 3. Biomechanical deformity was seen in 54.3%, 39% had PAD, 35.5% had PN and 6.5% had history of an ulcer or amputation. The multivariate analysis found that older age and having grades 2 and 3 of the IWGDF classification were independently associated with foot at risk of ulceration [OR 1.02 (95%CI 1.001-1.05). Conclusions: Almost 70% of the study population had high and very high risk for foot ulceration. Biomechanical deformities and PAD predominated as the most significant findings in this study.

Keywords : Diabetes mellitius; ulcer; diabetic foot.

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