Predictors of lower-extremity amputation in patients eith an infected diabetic foot ulcer

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059344" target="_blank" >RIV/00023001:_____/15:00059344 - isvavai.cz</a>

Result on the web

<a href="http://care.diabetesjournals.org/content/38/5/852.full.pdf+html" target="_blank" >http://care.diabetesjournals.org/content/38/5/852.full.pdf+html</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.2337/dc14-1598" target="_blank" >10.2337/dc14-1598</a>

Result language

angličtina

Original language name

Predictors of lower-extremity amputation in patients eith an infected diabetic foot ulcer

Original language description

OBJECTIVEInfection commonly complicates diabetic foot ulcers and is associated with a poor outcome. In a cohort of individuals with an infected diabetic foot ulcer, we aimed to determine independent predictors of lower-extremity amputation and the predictive value for amputation of the International Working Group on the Diabetic Foot (IWGDF) classification system and to develop a risk score for predicting amputation.RESEARCH DESIGN AND METHODSWe prospectively studied 575 patients with an infected diabetic foot ulcer presenting to 1 of 14 diabetic foot clinics in 10 European countries.RESULTSAmong these patients, 159 (28%) underwent an amputation. Independent risk factors for amputation were as follows: periwound edema, foul smell, (non)purulent exudate, deep ulcer, positive probe-to-bone test, pretibial edema, fever, and elevated C-reactive protein. Increasing IWGDF severity of infection also independently predicted amputation. We developed a risk score for any amputation and for amputations excluding the lesser toes (including the variables sex, pain on palpation, periwound edema, ulcer size, ulcer depth, and peripheral arterial disease) that predicted amputation better than the IWGDF system (area under the ROC curves 0.80, 0.78, and 0.67, respectively).CONCLUSIONSFor individuals with an infected diabetic foot ulcer, we identified independent predictors of amputation, validated the prognostic value of the IWGDF classification system, and developed a new risk score for amputation that can be readily used in daily clinical practice. Our risk score may have better prognostic accuracy than the IWGDF system, the only currently available system, but our findings need to be validated in other cohorts.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FB - Endocrinology, diabetology, metabolism, nutrition

OECD FORD branch

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Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2015

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Diabetes care

ISSN

0149-5992

e-ISSN

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Volume of the periodical

38

Issue of the periodical within the volume

5

Country of publishing house

US - UNITED STATES

Number of pages

6

Pages from-to

852-857

UT code for WoS article

000353505600027

EID of the result in the Scopus database

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