A comparison of diabetic smokers and non-smokers who undergo lower extremity amputation: a retrospective review of 112 patients

BACKGROUND: A diabetic foot or lower extremity amputation may be exacerbated by or related to the smoking habits and history of the patient. PATIENTS AND METHODS: Of the 112 diabetic patients in this retrospective study, 46 were non-smokers and 66 were smokers. The smokers were further categorized into patients who: 1) did not cease smoking; 2) ceased in the immediate post-operative period but resumed within 3 months; and 3) ceased up to and at the 3-month post-operative period. The patients were also divided by their amputation level of forefoot, midfoot/rearfoot, and proximal leg. RESULTS: Smoking diabetic patients underwent more amputations, as well as more proximal amputations than those who did not smoke. The higher amount of smoking in pack years followed an increasing trend of more proximal amputations as well. CONCLUSION: Neither the amputation level nor the amputation itself was enough motivation for the patients to participate in smoking cessation.