Predictors of surgical management in diabetic foot infections.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-06-01 DOI:10.12968/jowc.2021.0010

Tuna Demirdal, Pinar Sen

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Abstract

Objective: Early recognition of the need for surgical intervention is crucial in terms of limiting amputation level and decreasing mortality. We aimed to determine the risk factors for limb loss in patients with diabetic foot infection (DFI).

Method: Data of hospitalised patients with a DFI between 2010 and 2019 were collected retrospectively from their hospital records. Clinical and laboratory findings were analysed according to the type of treatment.

Results: Data were collected for 401 patients, 280 (69.8%) of whom were male. The mean age was 59.6±11.1 years. Treatment modalities included: medical treatment (36.4%); debridement/drainage (21.9%); minor amputation (17.7%); and major amputation (23.9%). Forefoot infection (odds ratio (OR): 3.347; 95% confidence interval (Cl): 1.408-7.956) and peripheral arterial disease (OR: 4.990; 95% Cl: 1.225-20.324) were found to be significant in predicting limb loss, while duration of diabetes (≥20 years) and absence of forefoot infection were significant predictors of debridement/drainage. Subgroup analysis showed that high leukocyte levels (>16.4K/μl) and forefoot infections were independent predictors for major and minor amputation, respectively.

Conclusion: The clinical parameters used in this study are simple, broadly available, cost-effective and promising for predicting limb loss in patients with DFI.

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糖尿病足感染手术治疗的预测因素。

目的：早期识别手术干预的必要性对于限制截肢水平和降低死亡率至关重要。我们旨在确定糖尿病足感染（DFI）患者肢体缺失的风险因素：方法：我们从住院病历中回顾性收集了 2010 年至 2019 年糖尿病足感染住院患者的数据。根据治疗类型对临床和实验室结果进行分析：结果：共收集到 401 名患者的数据，其中 280 人（69.8%）为男性。平均年龄为（59.6±11.1）岁。治疗方式包括：药物治疗（36.4%）；清创/引流（21.9%）；小截肢（17.7%）；大截肢（23.9%）。前足感染（几率比（OR：）3.347；95% 置信区间 (Cl)：糖尿病病程（≥20 年）和无前足感染是清创/引流的重要预测因素。亚组分析显示，高白细胞水平（>16.4K/μl）和前足感染分别是大截肢和小截肢的独立预测因素：本研究采用的临床参数简单、可用性广、成本效益高，有望预测 DFI 患者的肢体缺失情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.