Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey

Autor: Gonul Sengoz, Nazan Tuna, U. Tozalgan, Funda Şimşek, Oguz Karabay, Kadriye Kart Yaşar, Meral Sonmezoglu, Asli Vatan, Fahri Yilmaz, B. Erturk, M. Ozyazar, Onder Ergonul, Fatma Sargin, Serdar Özer, Yasar Kucukardali, Atahan Cagatay, Nurgul Ceran, Hakan Ay, Ayse Batirel, Yasemin Akkoyunlu, Mucahit Yemisen, Filiz Pehlivanoglu, Derya Ozturk Engin, Ayten Kadanali, Lutfiye Mulazimoglu, Haluk Eraksoy, Oral Oncul, Taner Yildirmak, Nuray Uzun, Nail Ozgunes, Oznur Ak, Gül Karagöz, Nese Saltoglu, Turan Aslan
Přispěvatelé: AKKOYUNLU, YASEMİN, Saltoglu, N., Yemisen, M., Ergonul, O., Kadanali, A., Karagoz, G., Batirel, A., Ak, O., Eraksoy, H., Cagatay, A., Vatan, A., Sengoz, G., Pehlivanoglu, F., Aslan, T., Akkoyunlu, Y., Engin, D., Ceran, N., Erturk, B., Mulazimoglu, L., Oncul, O., Ay, H., Sargin, F., Ozgunes, N., Simsek, F., Yildirmak, T., Tuna, N., Karabay, O., Yasar, K., Uzun, N., Kucukardali, Y., Sonmezoglu, M., Yilmaz, F., Tozalgan, U., Ozer, S., Ozyazar, M.
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
Microbiology (medical)
medicine.medical_specialty
Turkey
medicine.medical_treatment
Antimicrobial resistance
Amputation
Surgical
Risk Factors
Diabetes mellitus
Internal medicine
OSTEOMYELITIS
MANAGEMENT
medicine
Humans
EPIDEMIOLOGY
infections
LOWER-EXTREMITY AMPUTATION
Aged
Retrospective Studies
an observational retrospective multicentric study in Turkey-
CLINICAL MICROBIOLOGY AND INFECTION
cilt.21
ss.659-664
2015 [Saltoglu N.
Yemisen M.
Ergonul O.
KADANALI A.
KARAGOZ G.
BATIREL A.
AK O.
Eraksoy H.
Cagatay A.
Vatan A.
et al.
-Predictors for limb loss among patient with diabetic foot infections]
medicine.diagnostic_test
Vascular disease
business.industry
General Medicine
Middle Aged
medicine.disease
limb loss
Diabetic foot
Gram-negative
Surgery
Infectious Diseases
Amputation
Erythrocyte sedimentation rate
Cellulitis
Etiology
Female
business
diabetic foot
Retinopathy
Popis: We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum beta-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% Cl 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% Cl 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% Cl 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% Cl 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% Cl 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% Cl 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% Cl 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Databáze: OpenAIRE
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