A study of prognostic factors in Chinese patients with diabetic foot ulcers

Abstract

ObjectiveFew studies have identified factors as predictors of clinical prognosis of patients with diabetic foot ulcers (DFUs), especially of Chinese patients. In this study, we assessed the prognostic factors of Chinese patients with DFUs.Methods and materialsThis was a retrospective study (January 2009–January 2011) of 194 DFUs conducted in an inpatient population at PLA 454 Hospital in Nanjing, China, to determine the prognostic influential factors of DFUs in Chinese patients. All of the studied patients were grouped into an amputation group, a non-healing group, and a cured group, according to the clinical prognosis. Patient parameters, including gender, age, smoking habits, education level, family history of diabetes mellitus, medical history, duration of foot lesions and complications, ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), urinary albumin/creatinine ratio (Alb/Cr), fundus oculi, electrocardiogram, DFU characteristics, bacterial nature, and neuropathy, were cross-studied among the three groups.ResultsCompared with the other two groups, the amputation group showed a higher number of males, older in age, lower ABI and TcPO2 levels, higher Wagner wound grading and size, and significantly higher urinary Alb/Cr ratio, blood urea nitrogen, serum creatinine, white blood cell count, and erythrocyte sedimentation rate. Compared to the cured group (162 patients), more patients with an older age, smoking, family history of diabetes mellitus, medical history of foot ulcerations, lower ABI and TcPO2 levels, higher urine Alb/Cr ratio, and serum creatinine were found in the non-healing group. Regression analysis was used to study the correlation between various factors and clinical prognosis, and the results were as follows: age, Wagner wound classification, and heel ulcerations were negatively correlated to the DFU prognosis, whereas the female population, ABI, and TcPO2 were positively correlated with DFU prognosis.ConclusionIn this retrospective study, we conclude that the DFU prognosis may be related to age, gender, wound location (heel), Wagner wound classification, ABI, and TcPO2 levels in the Chinese population.

Risk of Diabetic Foot in Diabetics With Micro and Macrovascular Complications

“…Wang 21 also found that an abnormal ABI was more prevalent in patients with non-healing ulcers. High risk was also more prevalent among diabetics with reduced palpability of lower limb pulses (14.04%); correlating with Margolis, in whose study of diabetic foot patients, 20% had distal vasculopathy.…”

Comparing the Meggitt‐Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter‐observer analyses

“…The MW system seems to correlate with the prognosis of diabetic foot ulcers (18), while the stages in the UT system were found to be helpful to predict amputation (11). In contrast to other classification systems such as the S(AD)SAD (16) and the PEDIS (perfusion, extent, depth, infection and sensation) (4), the MW and the UT systems do not assess ulcer site, degree of polyneuropathy or surface area.…”

Potential prognostic factors for delayed healing of common, non‐traumatic skin ulcers: A scoping review

“…Other results from clinical investigations included serum albumin (8/42), serum haemoglobin (7/42), glycaemic control (eg, HAb1C) (7/42), and renal function (eg, estimated glomerular filtration rate) (5/42). Only two studies investigated microbiology clinical investigations …”