Reevaluating the way we classify the diabetic foot: Restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot
Reevaluating the way we classify the diabetic foot: Restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot
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DOI：
10.2337/dc07-1302
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发表时间：
2008-01-01
期刊：
影响因子：
16.2
通讯作者：
Lavery, David C.
中科院分区：
文献类型：
--
作者：
Lavery, Lawrence A.;Peters, Edgar J. G.;Lavery, David C.
目的：在糖尿病足风险分类中分别评估周围动脉闭塞(PAOD)和足部溃疡和截肢病史以预测足部并发症。研究设计和方法-我们对1,666名糖尿病患者进行了27.2+/-4.2个月的评估。患者接受了详细的足部评估，并定期进行跟踪。我们使用国际糖尿病足工作组风险分类的修订版来评估随访期间的并发症。结果：随着风险组的增加(趋势P<；0.001的X-2)，有更多的溃疡、感染、截肢和住院。当危险类别2(神经病变和畸形和/或PAOD)按PAOD分层时，PAOD患者的并发症更多(P<；0.01)。当风险组3患者(溃疡或截肢病史)被单独分层时，既往截肢的患者有更多的并发症(P<；0.01)。结论：我们提出了一个新的风险分类，它比IWGDF目前使用的风险分类更能预测未来的足部并发症。
OBJECTIVE - To separately evaluate peripheral arterial occlusive disease (PAOD) and foot ulcer and amputation history in a diabetic foot risk classification to predict foot complications.RESEARCH DESIGN AND METHODS - We evaluated 1,666 diabetic patients for 27.2 +/- 4.2 months. Patients underwent a detailed foot assessment and were followed at regular intervals. We used a modified version of the International Working Group on the Diabetic Foot's (IWGDF's) risk classification to assess complications during the follow-up period.RESULTS - There were more ulcerations, infections, amputations, and hospitalizations as risk group increased (X-2 for trend P < 0.001). When risk category 2 (neuropathy and deformity and/or PAOD) was stratified by PAOD, there were more complications in PAOD patients (P < 0.01). When risk group 3 patients (ulceration or amputation history) were separately stratified, there were more complications in subjects with previous amputation (P < 0.01).CONCLUSIONS - We propose a new risk classification that predicts future foot complications better than that currently used by the IWGDF.