Association of anaemia in patients with diabetic foot disease

Abstract

s / International Journal of Surgery 10 (2012) S53–S109 S105 ABSTRACTS 0374: DOES SOCIO-ECONOMIC STATUS INFLUENCE AMPUTATION OUTCOMES? Risha Gohil, Rachel Barnes, Ian Chetter. Hull York Medical School, University of Hull, Hull Royal Infirmary, Hull & E Yorkshire Hospital Trust, Hull, UK Aims: To analyse the effect of socioeconomic deprivation on amputation outcome.Currently 5,000 leg amputations occur annually in England and Wales and have a 50% mortality rate at 2 years. Methods: All patients undergoing major lower limb amputation from January 2005 to December 2009 were identified from a prospectively maintained vascular database. Patient's postcodes were used to determine socioeconomic status using the ACORN classification system (1 highest group to 5 lowest). Non parametric analysis of data was performed using SPSS version 19. Results:We identified354patients (218men;65.5%),medianage68 (IQR5878) years. 47 (14.8%) patients were ACORN grade 1, 4 (1.3%) were grade 2, 65 (20.4%) were grade 3, 56(17.6%) were grade 4 and 146 (45.9%) were grade 5. Significant differences were noted for the cardiovascular risk factors; hyper-cholesterolaemia (p1⁄40.034), diabetes (p1⁄40.020), smoking status (p1⁄40.006). No significant differences were noted between classes for gender, type of admission (emergency or elective) or mortality (perioperative or 1 year death rate) or blood test (haemoglobin, white cells, urea, creatinine, sodium and potassium). Conclusions: Socio-economic status of amputees does not have an effect on mortality. However, their status does impact on their cardiovascular risk factors, therefore aggressive modification remains imperative. 0414: ASSOCIATION OF ANAEMIA IN PATIENTS WITH DIABETIC FOOT DISEASE Mustafa Khanbhai, Stavros Loukogeorgakis, Steven Hurel, Richards Toby. University College London, London, UK Aims: Anaemia and inflammation have been shown to play a role in diabetic foot disease. We aim to explore the association between anaemia and inflammation, particularly with stage of diabetic foot disease. Methods: 175 patients with diabetic foot disease were studied retrospectively. Patients were stratified in groups according to severity of diabetic foot disease according to NICE guidelines; D1 to D4, the lowest risk assigned; D1. Correlation with baseline haemoglobin, C-reactive protein (CRP) and creatinine was evaluated. Longitudinal analysis of stage of diabetic foot disease was analysed. Results: Haemoglobin was 13.2, 12.3, 11.0 and 9.3 and CRP was 6.1, 22.8, 32.4 and 39.5 in patients stratified to group D1, D2, D3 and D4 respectively (P 5.5cm) infra-renal AAA between 1st January 2008 and 31st December 2009 were included. Patients were classified into two groups; those managed non-operatively, or those offered elective repair. Survival was reported by Kaplane Meier analysis. Multivariate analysis investigated factors leading to non-operative management. Results: 251 patients with a mean (SD) age of 75(8) years were assessed. Thirty-two(13%) patients were deemed unsuitable for repair, mostly because of medical co-morbidity (16/32). 219/251(87%) patients underwent repair(25/251(10%) open repair 194/251(77%) EVAR)with 1/219(0.5%) 30-day mortality. AAA repair was associated with significantly greater survival (p<0.001,log-rank test) at 2years. In multivariate analysis Glasgow Aneurysm Score, female gender and respiratory disease were significant predictors of the decision to treat patients conservatively(p< 0.001). Conclusion:Most patients were suitable for surgical interventionwith low perioperative mortality. Data on turndown rates should be routinely reported to quantify the denominator for operative success. 0593: MULTI-LEVEL BYPASS GRAFTING – IS IT WORTH IT? Alistair Sharples, Mark Kay, Anthony Fox, Tim Sykes, Andrew Houghton. Shrewsbury and Telford NHS Trust, Shrewsbury, UK Traditionally multi-level arterial disease has been treated with an inflow procedure only but simultaneous multi-level bypass graft procedures have