The diabetic foot

Khanolkar, Manish; Bain, Stephen C.; Stephens, J. W.

doi:10.1093/qjmed/hcn027

Cited by 150 publications

(122 citation statements)

References 79 publications

Supporting

Mentioning

119

Contrasting

Order By: Relevance

“…This search retrieved 2,275 studies. These were considered further if they met the following selection criteria: (1) publication date up to and including 15 April 2010; (2) published in the following languages: English, French, Italian, Spanish or Portuguese; (3) type of study: reviews, randomised controlled trials or cohort, case-control and cross-sectional studies; (4) studies that described the creation of or evaluated diabetic foot ulcer risk degree stratification systems; and (5) results that described the creation or modification (by the same group) and/or evaluated the effectiveness of one or several diabetic foot ulcer risk degree stratification systems.…”

Section: Methodsmentioning

confidence: 99%

“…Diabetes mellitus is one of the most frequent metabolic disorders [1,2], achieving an epidemic magnitude [2], of nearly 3% prevalence worldwide [3], with an expected increment to more than 4% in 2030 [3,4]. This significant rise combined with insufficient healthcare resources will make it increasingly necessary to further improve prevention and treatment of diabetic foot complications [5].…”

Section: Introductionmentioning

confidence: 99%

“…Hence, various studies have concluded that amputation is always more expensive than its prevention [10]. Therefore, it is crucial to define a standardised and efficient approach to prevention of foot ulceration and consequently amputation [2]. The first step should be the correct identification of degree of risk for foot ulceration in all patients [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk stratification systems for diabetic foot ulcers: a systematic review

et al. 2011

View full text Add to dashboard Cite

Aims/hypothesis Several risk stratification systems have been proposed for predicting development of diabetic foot ulcer. However, little has been published that assesses their similarities and disparities, diagnostic accuracy and evidence level. Consequently, we conducted a systematic review of the existing stratification systems. Methods We searched the MEDLINE database for studies (published until April 2010) describing the creation and validation of risk stratification systems for prediction of diabetic foot ulcer development. Results We included 13 studies describing or evaluating the following different risk degree stratification systems: University of Texas; International Working Group on Diabetic Foot; Scottish Intercollegiate Guideline Network (SIGN); American Diabetes Association; and Boyko and colleagues. We confirmed that five variables were included in almost all the systems: diabetic neuropathy, peripheral vascular disease, foot deformity, and previous foot ulcer and amputation. The number of variables included ranged from four to eight and the number of risk groups from two to six. Only four studies reported or allowed the calculation of diagnostic accuracy measures. The SIGN system showed some higher diagnostic accuracy values, particularly positive likelihood ratio, while predictive ability was confirmed through external validation only in the system of Boyko et al. Conclusions/interpretation Foot ulcer risk stratification systems are a much needed tool for screening patients with diabetes. The core variables of various systems are very similar, but the number of included variables in each model and risk groups varied greatly. Overall, the quality of evidence for these systems is low, as little validation of their predictive ability has been done.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk stratification systems for diabetic foot ulcers: a systematic review

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Diabetic foot is characterized by sensory, motor and autonomic neuropathy and peripheral vascular disease, which may lead to the development of ulceration, infection and gangrene (2). The ultimate outcome of diabetic foot is amputation, which is associated with relatively high morbidity and mortality (3). It has been estimated that ~15% of patients with diabetes develop foot ulcers and 15-20% of these foot ulcers require a lower extremity amputation (LEA) (4).…”

Section: Introductionmentioning

confidence: 99%

Smoking increases the risk of diabetic foot amputation: A meta-analysis

et al. 2017

View full text Add to dashboard Cite

Abstract. Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I 2 statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; P<0.0001) compared with non-smoking. Sensitivity analysis demonstrated that the pooled analysis did not vary substantially following the exclusion of any one study. Additionally, there was no evidence of publication bias (Egger's test, t=0.1378; P=0.8958). Furthermore, no significant difference was observed between the minor and major amputation groups in patients who smoked (OR=0.79; 95% CI, 0.24-2.58). The results of the present meta-analysis suggested that smoking is a notable risk factor for diabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation.

show abstract

“…Nevertheless, imipenam resistant Pseudomonas appears as a new challenging problem especially in hospitalized patient [13]. Imipenem resistance was observed in (61.2%) of the isolates in Brazil [14].…”

Section: Introductionmentioning

confidence: 99%