Risk Factors, Microbiology, and Prognosis of Diabetic Foot Osteomyelitis: A Retrospective Cohort Study.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2025-01-29 DOI:10.1016/j.eprac.2025.01.007

Jun Ren, Hao Gao, Wen Luo, Shuaikun Lu, Congxiao Fu, Hu Wang, Guoliang Wang, Zhenfeng Zhu, Yong Zhang, Yunfei Zhang

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引用次数: 0

Abstract

Objective: To determine risk factors, microbiology, and prognosis of diabetic foot osteomyelitis (DFO).

Methods: We conducted a retrospective cohort study of 456 persons diagnosed with diabetic foot disease admitted to a grade-A tertiary hospital from January 2012 to December 2022. Multifactorial Cox regression was used to analyze independent risk factors for DFO. Medical records were reviewed to determine etiologic agents and antibiotic susceptibility profiles. In addition, 5-year survival rates of all DFO patients and those undergoing amputation were analyzed using Kaplan-Meier curves.

Results: Multivariate Cox regression identified higher Wagner grades (hazard ratio 3.17, 95% confidence interval 2.04, 4.94) as independent risk factors for DFO. In the DFO group, a total of 62 patients had positive bone or deep tissue cultures. The most prevalent Gram-positive bacterial isolates were Staphylococcus aureus (11.29%) and Enterococcus faecalis (11.29%), while Gram-negative infections were caused most often by Proteus vulgaris (4.84%). Polymicrobial infections were common (27.41%). Five-year survival rates were lower among DFO patients than in matched DF controls, and lower among major amputation than minor amputation and nonamputation DFO patients.

Conclusions: Higher Wagner grades were independent risk factors for DFO. Major amputation does not improve 5-year survival rates in DFO patients.

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.