Identification of the prognostic factors of patients with diabetic foot ulcer treated with tibial cortex transverse transport surgery

Abstract

Objectives: The aim of this study was to establish a clinical prediction model to predict the prognosis of diabetic foot ulcer (DFU) patients treated with tibial cortex transverse transport surgery (TTT). Methods: This was a single-center, retrospective study. The clinical data and inspection results were collected by following up on DFU patients hospitalized at the First Affiliated Hospital of Guangxi Medical University and treated with TTT surgery. 202 patients’ clinical data were collected finally and they were divided into two groups according to Wagner’s grading classification. The indicators related to the severity of DFU and with the time of wound healing after surgery were confirmed through logistic regression and Lasso regression analysis. In addition, a clinical prediction model was established. Finally, the intersection of the two sets of indicators yielded the indicators related to wound severity and the postoperative healing time. Results: 202 patients were separated into Wagner 2/3 group(n=135,mean age 62.40±9.68 years) and Wagner 4 group(n=67, mean age 61.12±9.07 years).After the student’s t-test, Lasso regression, and Logistic regression analysis, three factors were identified to describe the severity of the DFU between the two groups: platelet-to-lymphocyte ratio (PLR) (OR: 0.992, 95% CI: 0.987-0.998), monocyte-to-neutrophil ratio (MNR) (OR: 0.000, 95% CI: 0.000-0.050), Hemoglobin (HGB) (OR: 0.965, 95% CI: 0.938-0.992). Univariate COX regression analysis determined 12 factors (PLR, MNR, ect) related to the healing time after the operation. Conclusions: PLR and MNR were factors related to DFU severity and prognosis after TTT surgery.