Preoperative hemoglobin level and anemia frequency among patients admitted for diabetic lower extremity amputation

Objectives Anemia is known to be prevalent in patients with diabetic foot ulcers, but such was not documented in those who required lower extremity amputations (LEAs). In this high-risk population, preoperative anemia could be an additional risk factor for postoperative morbidity and mortality. This study attempts to address the knowledge gap related to the preoperative hemoglobin (Hg) level and anemia prevalence in patients admitted for diabetic LEA.Methods Using a cross-sectional design, the primary outcomes were defined as the mean preoperative Hg level and anemia frequency. Mean differences and sex-based results were calculated and compared between three categories: major, midfoot, and forefoot amputation groups. Correlation between Hg level and serum creatinine was set as a secondary outcome.Results A total of 141 patients comprising 192 amputation cases were included. The mean Hg value for the whole sample was 10.6 +/- 1.8 g/dl. Only 18 patients (9.7%) had a normal Hg level and 174 (90.3%) were anemic: 90 cases (46.8%) with mild anemia, 76 (40.8%) with moderate anemia, and 8 cases (4.3%) with severe anemia. No significance was found between mean Hg values of the three groups or between sex groups. A significant negative correlation between the levels of serum creatinine and Hg was found (p = .037).Conclusions An overwhelming majority of patients admitted for diabetic LEA were anemic. Since anemia could impede limb perfusion and induce higher postoperative mortality rate, adjusting this confounder could be justified. Future research should aim to evaluate the impact of preoperative blood component transfusion on postoperative complications following diabetic LEA.