Predictors of amputation in patients with diabetic foot ulcers: a multi-centre retrospective cohort study.

Autor: Che D; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Jiang Z; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Xiang X; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Zhao L; The Second People's Hospital of Hefei, Hefei, China., Liu X; Taihe Hospital of Wannan Medical College, Shiyan, China., Zhou B; The Affiliated Hospital of North Anhui College of Health Professions, Hefei, China., Xie J; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Li H; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Lv Y; The Second Affiliated Hospital of Anhui Medical University, Hefei, China., Cao D; The Second Affiliated Hospital of Anhui Medical University, Hefei, China. caodongsheng@ahmu.edu.cn.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2024 Jul; Vol. 85 (1), pp. 181-189. Date of Electronic Publication: 2024 Feb 08.
DOI: 10.1007/s12020-024-03704-8
Abstrakt: Purpose: Investigating risk factors for amputation in patients with diabetic foot ulcer (DFU) and developing a nomogram prediction model.
Methods: We gathered case data of DFU patients from five medical institutions in Anhui Province, China. Following eligibility criteria, a retrospective case-control study was performed on data from 526 patients.
Results: Among the 526 patients (mean age: 63.32 ± 12.14), 179 were female, and 347 were male; 264 underwent amputation. Univariate analysis identified several predictors for amputation, including Blood type-B, Ambulation, history of amputation (Hx. Of amputation), Bacterial culture-positive, Wagner grade, peripheral arterial disease (PAD), and laboratory parameters (HbA1c, Hb, CRP, ALB, FIB, PLT, Protein). In the multivariate regression, six variables emerged as independent predictors: Blood type-B (OR = 2.332, 95%CI [1.488-3.657], p < 0.001), Hx. Of amputation (2.298 [1.348-3.917], p = 0.002), Bacterial culture-positive (2.490 [1.618-3.830], p <0.001), Wagner 3 (1.787 [1.049-3.046], p = 0.033), Wagner 4-5 (4.272 [2.444-7.468], p <0.001), PAD (1.554 [1.030-2.345], p = 0.036). We developed a nomogram prediction model utilizing the aforementioned independent risk factors. The model demonstrated a favorable predictive ability for amputation risk, as evidenced by its area under the receiver operating characteristics (ROC) curve of 0.756 and the well-fitted corrected nomogram calibration curve.
Conclusion: Our findings underscore Blood type-B, Hx. Of amputation, Bacterial culture-positive, Wagner 3-5, and PAD as independent risk factors for amputation in DFU patients. The resultant nomogram exhibits substantial accuracy in predicting amputation occurrence. Timely identification of these risk factors can reduce DFU-related amputation rates.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: