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A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 December;173(12):611-9
Seasonal variations in foot gangrene and extremity amputations
Has B. 1, 2, Lehner V. 1, Čandrlić K. 1, Pinotić K. 1, Ištvanić T. 1, Flam D. 1, Kovač D. 1, Has-Schön E. 3
1 Department of Surgery, Clinical Hospital Osijek, Osijek, Croatia;
2 J.J. Strossmayer University, Medical Faculty, Osijek, Croatia;
3 J.J. Strossmayer University, Department of Biology, Osijek, Croatia
AIM: The aim of our study was to investigate the influence of PTH and vitamin D periodical changes, on extremity amputation incidence due to gangrene development.
METHODS: This study includes 1439 elderly patients, 224 with (KD) and 1215 without (noKD group) accompanying kidney disease, amputated at the Surgical Department of the Clinical Hospital in Osijek, Croatia, in the nine years period. Total number of amputations was correlated with number of sunny hours in the each month of the analyzed period. Comparisons of mean amputation frequency were also performed between selected month(s).
RESULTS: Almost all performed amputations had to be done on lower extremities. The level of amputation differed between groups: in KD group there were more leg (upper and lower part), and in noKD group more leg finger amputations. A significant negative correlation between winter and summer (without July) months was recorded for KD group, while no such correlation could be shown for noKD group, were slightly higher number of amputations were found in summer compared to winter months.
CONCLUSION: In both patient groups, PTH activity is crucial for gangrene development. In KD patients, higher PTH activity and low vitamin D quantities might cause greater incidence of amputation in winter months. In noKD patients, a facilitated PTH activity in combination with high vitamin D quantities might cause high frequency of gangrene incidence also in summer months. In addition, it is evident that kidney disease contributes to severity of gangrene development, demanding higher levels of amputation.