DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20175439

Study on the effectiveness of clinical scoring in predicting the outcome of diabetic foot

Sherine E. K., Sasi M. P.

Abstract


Background: Diabetic patients will develop diabetic foot ulcerations of which 14-20% will go on to amputation. By this study we aimed to investigate the effectiveness of clinical scoring system predicting the outcome of diabetic foot and also to know whether neuropathy or vasculopathy predominated in these patients.

Methods: Patients with Type 2 diabetic ulcers are selected, and the ulcer was graded according to Wagner’s grading. The vasculopathy and Neuropathy were assessed by Doppler study and monofilament tests respectively. The patients were grouped based on the grade of ulcer and presence or absence of neuropathy and vasculopathy. These patients were followed up for a duration of 1 year.

Results: The patients belonging up to group 6 had better outcome(healing) on conservative management and those in group 8 and group 9 had a bad outcome (amputations). 66% of patients had neuropathy predominance.

Conclusions: Even though clinical scoring system could predict the outcome, statistically it is not found to be significant. Neuropathy was the more predominant factor among the patients with diabetic foot.


Keywords


Amputations, Diabetic foot

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References


Palumbo PJ, Melton LJ III. Peripheral Vascular Disease and Diabetes. In: National Diabetes Data Group (US), National Institute of Diabetes and Digestive and Kidney Diseases (United States), eds. Diabetes in America. Bethseda MD; National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases;1995:401-408.

Adler AI, Boyko EJ, Ahroni JH, Smith DG. Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetes Care. 1999(7):1029-1035.

International working group on the diabetic foot. International consensus on the diabetic foot. Apelqvist J, Bakker K, Van Houtum WH, Babuurs-Franssen MH, Schaper NC eds. Maastricht, Schaper NC: 1999.

Jeffcoate WJ, van Houtum WH. Amputation as a marker of the quality of foot care in diabetes. Diabetologia. 2004;47(12):2051-8.

Ramachandran A. Specific problems of the diabetic foot in developing countries. Diabetes Metab Res Rev. 2004;20:Suppl 1:S19-22.

Pzendesy SP. Epidemiological aspects of diabetic foot. Int J Diabetes Dev countries. 1994;14: 7-38.

Vijay V, Snehalatha C, Ramachandran A. Sociocultural practices that may affect the development of the diabetic foot. IDF Bull. 1997;42:10-12.

Katoulis EC, Ebdon-Parry M, Hollis S, Harrison AJ, Vileikyte L, Kulkarni J, et al. Postural instability in diabetic neuropathic patients at risk of foot ulceration. Diab Med. 1997;14(4):296-300.

Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM. Preventive foot care in people with diabetes. Diabetes care. 1998;21(12):2161-77.

Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J et al. The Northwest Diabetes Foot Care study: incidence of and risk factors for new diabetic foot ulcers in a community based cohort. Diabetes Med. 2002.

Bal A, Das AK, Pendsey S, Suresh KR, Vishwanathan V, Ambardekar P. Handbook of diabetic foot care. Diabetic Foot Society of India, Bangalore. 2005.