Diabetic foot score: a predictive model for leg amputation in patients with diabetic foot disease

  • Agustinus Vincent Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Soebagijo Adi Soelistijo Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Deasy Ardiany Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Agung Pranoto Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Michael Austin Pradipta Lusida Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Lukita Pradhevi Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Rendra Prasetya Saefudin Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
DOI: https://doi.org/10.13181/mji.oa.247427
Keywords: amputation, diabetic foot, leg, risk factors
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Abstract

BACKGROUND Patients with diabetes mellitus are at a higher risk for peripheral artery disease (PAD) and diabetic foot disease (DFD), which can ultimately result in leg amputation. This study aimed to develop a novel scoring system to predict the risk of leg amputation using widely available modalities, including demographic characteristics and various laboratory data.

METHODS This study was conducted at Dr. Soetomo General Hospital and analyzed risk factors for leg amputation in 99 patients with DFD who underwent leg amputation compared with 80 control patients. This study presented a predictive model for leg amputation in patients with DFD, using odds ratio (OR) analysis and logistic regression approach with confidence intervals (CIs) set at 95%. The data analysis was conducted using SPSS software version 25.0.

RESULTS PAD (OR 6.52, 95% CI = 2.19–19.37, p = 0.001), high low-density lipoprotein cholesterol (OR 5.97, 95% CI = 2.31–15.43, p<0.001), type of DFD (OR 4.58, 95% CI = 2.14–9.79, p<0.001), poor glycemic control (OR 4.48, 95% CI = 1.78–11.28, p = 0.001), and neutrophil-to-lymphocyte ratio level (OR 1.04, 95% CI = 1.00–1.07, p = 0.025) were the independent predictors for leg amputation. The predictive model, developed using multivariate analysis with an area under the curve of 89%, optimum threshold of 0.5 (score 6), sensitivity of 84.8%, and specificity of 78.8%, indicating a promising approach for predicting leg amputation outcomes.

CONCLUSIONS The newly developed diabetic foot score may assist in making decisions regarding therapeutic options for patients with DFD.

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Published
2024-07-24
How to Cite
1.
Vincent A, Soelistijo SA, Ardiany D, Pranoto A, Lusida MAP, Pradhevi L, Saefudin RP. Diabetic foot score: a predictive model for leg amputation in patients with diabetic foot disease. Med J Indones [Internet]. 2024Jul.24 [cited 2024Jul.27];33(2):104-11. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/7427
Issue
Vol. 33 No. 2 (2024): June
Section
Clinical Research

Copyright (c) 2024 Agustinus Vincent, Soebagijo Adi Soelistijo, Deasy Ardiany, Agung Pranoto, Michael Austin Pradipta Lusida, Lukita Pradhevi, Rendra Prasetya Saefudin

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