Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot.

IF 0.5 4区医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-10-04 DOI:10.7547/23-233

Michael A Jones, Garrett S Bullock, Meghan M Crowfoot, David R Sinacore

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Abstract

Aims: We aimed to determine the relative risk of pedal vessel calcification (PVC) on major adverse foot events (MAFEs) and chronic kidney disease (CKD) stage in patients with diabetes mellitus (DM) and peripheral neuropathy (PN).

Methods: Retrospective electronic medical record review of 152 patients with diagnoses of DM, PN, and CKD stages 1-5 who had at least one foot x-ray obtained. PVC was scored (from 0-4) based on foot anatomic location and radiology reported MAFEs, which includes foot fracture, Charcot neuroarthropathy, foot ulcer, osteomyelitis, or minor amputation. Risk ratios (RR) with 95% confidence intervals (95% CI) and Poisson regressions were performed assessing the risk of sustaining MAFEs with number of PVCs and stage of CKD.

Results: The risk of any MAFE increased as PVC score increased (RR = 1.23); the risk of any MAFE increased as CKD stage increased (RR = 1.35); and risk of any PVC increased as CKD stage increased (RR = 1.71).

Conclusions: Pedal vessel calcification (PVC) on a foot radiograph increases the risk of any MAFE and increases with progressive stage of CKD. PVC may serve as a gateway to prompt investigation, treatment, or referral for at-risk diabetic neuropathic, nephropathic patients.

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糖尿病神经性和肾病性足部的足底血管钙化与足部重大不良事件的风险

目的：我们旨在确定糖尿病（DM）和周围神经病变（PN）患者足部血管钙化（PVC）对主要足部不良事件（MAFE）和慢性肾病（CKD）分期的相对风险：回顾性电子病历检查 152 名诊断为糖尿病、周围神经病变和慢性肾脏病 1-5 期的患者，这些患者至少接受过一次足部 X 光检查。根据足部解剖位置和放射科报告的 MAFEs（包括足部骨折、Charcot 神经关节病、足部溃疡、骨髓炎或轻微截肢）对 PVC 进行评分（0-4 分）。通过风险比（RR）、95% 置信区间（95% CI）和泊松回归评估了PVC次数和CKD分期的MAFE风险：任何MAFE的风险随着PVC评分的增加而增加（RR = 1.23）；任何MAFE的风险随着CKD分期的增加而增加（RR = 1.35）；任何PVC的风险随着CKD分期的增加而增加（RR = 1.71）：结论：足部X光片上的足底血管钙化（PVC）会增加任何MAFE的风险，并随着CKD分期的进展而增加。PVC可作为高危糖尿病神经病变、肾病变患者进行及时检查、治疗或转诊的途径。

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 the American Podiatric Medical Association 医学-整形外科

CiteScore

1.10

自引率

0.00%

发文量

128

审稿时长

6-12 weeks

期刊介绍： The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.