Efficacy of diabetic ulcer severity score in patients with diabetic foot ulcer in predicting prognosis (original) (raw)

Risk factors associated with poor outcome in diabetic foot ulcer patients

Turkish journal of medical sciences, 2017

Diabetic foot ulcers and related complications are a major cause of morbidity and hospital admissions. Our aim was to evaluate the risk factors associated with poor outcome in diabetic foot ulcers. A prospective study was conducted on patients with diabetic foot ulceration attending the Madinah Teaching Hospital from June 2014 to December 2015. Potential risk factors and laboratory test results at presentation were recorded and their association with outcome (healing vs. amputation) was analyzed using IBM SPSS Statistics for Windows, Version 22.0. In total, 112 patients were studied during our study period. The majority of the patients were male (60.7%) and aged 50 years and older (62.5%). Regarding the outcome, 68% healed completely, 27.7% underwent amputation, and 4.5% died during this period. Patient age of 50 and older, long duration of diabetes (>10 years), rural origin, and heel ulcers were significantly associated with poor outcome (P < 0.05). Patients with diabetes sho...

Assessment of Contributing Factors and Wound Severity in Diabetic Foot Ulcer -A Prospective Study

International Journal of Clinical Pharmacokinetics and Medical Sciences(IJCPMS), 2022

The study aims to assess the factors contributing to the development of Diabetic Foot Ulcer (DFU) and wound severity of ulcer in DFU, and also to assess the type of dressing used and provide relevant patient care education to patient with DFU. It is a prospective observational study conducted for 6 months, from November 2021 to April 2022 in the in-patient and out-patient facility of the surgery Department at ESIC Hospital, Nacharam, Hyderabad, Telangana in India. A total of 103 subjects were included in the study. The contributing factors of DFU and wound severity were assessed by Wagner-Meggitt classification system. This study concluded that along with hyperglycemia, hypertension (55.33%), traumas (33%) are the leading risk factors for DFU. The highest number of patients falls under moderate numbness. Various types of dressing used in different severity grade patients was assessed and was found that highest type of dressing used was saline dressing. Based on wound severity specific counselling points were provided to the patient to progress the wound healing process. Counselling regarding diabetic diet and lifestyle modification was provided based on the GRBS (Glycemic index) of the patients.

A Prospective Study of Factors Affecting On the Outcome in Diabetic Foot Ulcer Patients

Background: In diabetes mellitus patients there is a 15% increased lifetime risk of developing a foot ulcer. There have been many studies conducted to know the role of various risk factors that worsens the outcome in diabetic foot ulcers and among them important are reduced blood sugars levels, peripheral neuropathy, ischemia, joint deformity, and infection. This study was designed to evaluate various factors affecting on the outcome in diabetic patients with foot ulcers. Methods: A prospective study was conducted on 125 diabetic patients with foot ulcers who attended Sri Venkateshwara Ramnaraian Ruiya Government General Hospital, Tirupati. Patient age, sex, rural/urban origin, type and duration of diabetes, history of trauma, duration of ulcer, previous history of ulceration, previous treatment, and site of ulcer was recorded on the first visit. Outcomes recorded as complete healing or lower extremity amputation (LEA). LEA is defined as major amputation if there is loss of any part of the lower limb above the ankle and as minor if below this joint. Results: In the present study, the majority, 36% of the cases belong to the age group of 51-60 years. In patients with WBC count between 4000-11000 cells/cu.mm, 48.9% of cases managed conservatively, and in 11000-15000 cells/cu.mm, 32% of the cases had Minor amputation while in cases with WBC count >15000 cells/cu.mm, the majority (66.7%) had Major amputation. In the present study, creatinine levels >4.0 mg/dl was noted in 21.6% with mean creatinine level 2.79 ± 1.75. Conservatively managed with serum Creatinine 1.0mg/dl (75%) and 1.1-2.0 mg/dl (63.4%), while conservative treatment (34.1%) and Disarticulation (29.3%) were commonly done in cases with serum creatinine 2.1-4.0 mg/dl. In cases with serum Creatinine levels >4.0 mg/dl, 44.4% of the cases had Minor amputation, and 48.1% of cases had Major amputation, and the difference was found to be statistically significant (p = 0.000). Conclusion: From this study it was concluded that age, long duration of diabetes, ischemia, high serum creatinine and WBC levels were considered as the risk factors for the poor outcome in diabetic foot ulcer patients. Patients at high risk of foot complications need more frequent monitoring including counselling, professionally fitted footwear, and early referrals to a tertiary care centre with trained professionals in foot ulcer management.

Validation of a system of foot ulcer classification in diabetes mellitus

Diabetic Medicine, 2004

Objective The lack of a simple, robust classification of diabetic foot ulcers has critically hampered research into optimum patterns of care. We have therefore attempted validation of the previously published S(AD) SAD system, which is based on grading of ulcer features using simple clinical methods.

Prognosis of the outcome of severe diabetic foot ulcers with multidisciplinary care

Journal of Multidisciplinary Healthcare

Background: Approximately 2-4% of individuals worldwide with diabetes mellitus have foot ulcers. This study aims to assess the factors affecting the outcomes of severe foot ulcers in diabetic individuals. Methods: An analytical prospective cohort study was conducted from March 1st, 2015, to March 1st, 2017. A total of 34 individuals was selected. The study included patients with foot ulcers below the ankle who were at risk of amputation. All tests used a <5% level of significance and confidence interval of 95%. A Pearson's chi-squared test and binary multiple regression were performed to assess the factors related to healing. Results: Only 11.7% of the individuals required amputation; ulcers classified as 2/B according to the University of Texas Diabetic Foot Ulcer Classification System healed before the 1/B ulcers. Neuropathic ulcers were the most prevalent (58.8%); 61.8% healed after 1 year. Most of the individuals were overweight, 47.1% had reduced glomerular filtration rates, and 78.8% had glycated hemoglobin >7%. Body mass index and osteomyelitis were the two significant variables in logistic regression. Conclusions: In this study, osteomyelitis was the main complication related to the risk of amputation, and elevated body mass index and osteomyelitis were the significant factors that induced a slower healing time.

A prospective study on outcomes of diabetic foot ulcer patients with and without amputation

International journal of applied research, 2016

Background: The rising prevalence of diabetic foot ulcer, the biggest risk of diabetes mellitus imposes great burden on world health system. Pressure on existing human and material health resources contributes to this burden. A foot ulcer occurs in majority of the patients with diabetes. Due to this higher prevalence of diabetic foot ulcers, amputation remains a hardship to patients with diabetes. Our study highlights the early recognition and proper management of diabetic foot ulcer and thus minimizing the rate of amputation and hence the hardships, mortality and morbidity of the patients. Methods: A retrospective study on pre-operative and post operative outcomes of patients with diabetic foot ulcer. A total of 54 patients were selected and using data collection proforma, details such as socio-demography, co-morbidities, social and medication history was collected from the case folders. Data were analysed using SPSS and results were presented in tables. Result: Male patients were more prevalent among the 54 selected subjects during the study period. The most affected group was in the age range of 51-60 years while the least affected group was those below 40 years of age. Most of the patients were relieved or cured without any amputation. 37% of diabetic foot ulcer patients' undergone amputation and Rays amputation was the common procedure presented in our study. Conclusion: In diabetic foot ulcers, early recognition, comprehensive treatment and proper hygiene ensure rapid healing and prevent reulceration. This can safeguard patients from amputation.

The DEPA scoring system and its correlation with the healing rate of diabetic foot ulcers

The Journal of Foot and Ankle Surgery, 2004

The purpose of this study was to examine the validity of a new scoring system in predicting the outcome of diabetic foot ulcers. The scoring system (DEPA score) includes the depth of the ulcer (D), the extent of bacterial colonization (E), the phase of ulcer healing (P) and the associated underlying etiology (A). The scoring system was validated against the clinical outcome in terms of healing and lower-limb amputations. Eighty-four patients were included in the study: 32 patients had a DEPA score of Յ6, 34 patients had a DEPA score of 7 to 9, and 18 patients had a DEPA score of Ն10. Using the Spearman nonparametric correlation test, DEPA scoring system was accurate in predicting the outcome of management (correlation coefficient, 0.78; 95% confidence interval, 0.68 to 0.86; P Ͻ .0001) at a mean follow-up of 20 weeks. The correlation was further validated by using a linear regression model (r ϭ 0.85; slope best-fit value, 0.51; 95% confidence interval, 0.41 to 0.59; P Ͻ .0001). All patients with DEPA scores Յ6 had excellent healing, whereas only 15% of those with a score of Ն10 had complete healing in Ͻ20 weeks. In conclusion, an increasing DEPA score is associated with increased risk of amputation and poor healing. Furthermore, inclusion of the phase of ulcer healing into the DEPA system increases the accuracy of predicting the outcome of diabetic foot ulcers.