scholarly journals Designing a Logistic Regression Model for a Dataset to Predict Diabetic Foot Ulcer in Diabetic Patients: High-Density Lipoprotein (HDL) Cholesterol Was the Negative Predictor

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Seyyed Amir Yasin Ahmadi ◽  
Razieh Shirzadegan ◽  
Nazanin Mousavi ◽  
Ermia Farokhi ◽  
Maryam Soleimaninejad ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diabetic Foot ◽  
Logistic Regression Model ◽  
Density Lipoprotein ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hdl Cholesterol ◽  
Diabetic Patients ◽  
Final Model ◽  
Negative Predictor

Objectives. Although the risk factors for diabetic neuropathy and diabetic foot ulcer have been detected, there was no practical modeling for their prediction. We aimed to design a logistic regression model on an Iranian dataset to predict the probability of experiencing diabetic foot ulcers up to a considered age in diabetic patients. Methods. The present study was a statistical modeling on a previously published dataset. The covariates were sex, age, body mass index (BMI), fasting blood sugar (FBS), hemoglobin A1C (HbA1C), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), insulin dependency, and statin use. The final model of logistic regression was designed through a manual stepwise method. To study the performance of the model, an area under receiver operating characteristic (AUC) curve was reported. A scoring system was defined according to the beta coefficients to be used in logistic function for calculation of the probability. Results. The pretest probability for the outcome was 30.83%. The final model consisted of age ( β 1 = 0.133 ), BMI ( β 2 = 0.194 ), FBS ( β 3 = 0.011 ), HDL ( β 4 = − 0.118 ), and insulin dependency ( β 5 = 0.986 ) ( P < 0.1 ). The performance of the model was definitely acceptable ( AUC = 0.914 ). Conclusion. This model can be used clinically for consulting the patients. The only negative predictor of the risk is HDL cholesterol. Keeping the HDL level more than 50 (mg/dl) is strongly suggested. Logistic regression modeling is a simple and practical method to be used in the clinic.

scholarly journals Risk factor and Outcomes of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Nekemte Referral Hospital, Western Ethiopia:Prospective cohort study

2019 ◽  
Author(s):  
Firomsa Bekele ◽  
Legese Chelkeba ◽  
Ginenus Fekadu ◽  
Kumera Bekele
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Risk Factor ◽  
Cohort Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Referral Hospital ◽  
Foot Ulcers ◽  
Diabetic Patients

Abstract Background:Foot problems are very common in people with diabetes affecting up to 15% of diabetic patients during their lifetime throughout the world. Foot ulcers significantly contribute to morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long-term hospitalization and carry the risk of limb amputation. Despite this, no study has been done on risk factor and outcomes of diabetic foot ulcer in NRH. Methods: A general prospective cohort study of diabetes mellitus patients who had diabetic foot ulcer was conducted among diabetes patients of Nekemte referral hospital (NRH) from March15 to June 15, 2018. The Wagner classification of diabetic foot ulcer was used to assess the severity of foot ulcers. Multivariate logistic regression was used to analyze the associations between dependent variable and independent variables. Results: Over the study period, 115 diabetes foot ulcer patients were admitted to the Nekemte referral hospital; of these patients, 35(30.43%) were under gone (minor and major amputations) and 80(69.57%) were healed. Grade of diabetic foot ulcerAOR=1.7; 95% CI: 1.604, 4.789,inappropriate antibioticsAOR = 2.526; 95% CI: 1.767, 8.314, Overweight AOR = 2.767; 95% CI: 1.827, 9.252, obesity AOR = 3.020; 95% CI: 2.556, 16.397,blood glucose controlAOR = 2.592; 95% CI: 1.937, 7.168, and neuropathy AOR = 1.565; 95% CI: 1.508, 4.822 were found to be a risk factor for amputation in multivariable logistic regression analysis. Conclusion: Blood glucose level, higher body mass index (BMI), inappropriate antibiotics given, neuropathy, and advanced grade of diabetic foot ulcer were independent predictors of amputation. Provision of special emphasis for patients having neuropathy and advanced grade of diabetic foot ulcer, decreasing excessive weight gain, managing hyperglycemia, and appropriate antibiotics prescription practice would decrease outcomes of diabetic foot ulcer. Key words:Diabetic Foot Ulcer, Risk Factors, Outcomes,Nekemte Referral hospital

scholarly journals The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

2021 ◽  
Vol 10 (7) ◽  
pp. 1495
Author(s):  
Yu-Chi Wang ◽  
Hsiao-Chen Lee ◽  
Chien-Lin Chen ◽  
Ming-Chun Kuo ◽  
Savitha Ramachandran ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Early Period ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Control Group ◽  
Diabetic Patients ◽  
High Morbidity

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

scholarly journals DIABETIC FOOT INFECTIONS;

2008 ◽  
Vol 15 (01) ◽  
pp. 153-161
Author(s):  
MUHAMMAD SAEED AKHTAR ◽  
MAQSOOD AHMAD ◽  
MUHAMMAD BADAR BASHIR ◽  
Muhammad Irfan ◽  
Zahid Yasin Hashmie
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Surgical Department ◽  
Diabetic Foot Infections ◽  
Group A ◽  
Hospital Stays ◽  
Male Patients ◽  
Group B

Objective: (1) To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound (2) Tocompare the effects with conventional diabetic foot management. Design: Prospective, open, randomized comparativestudy. Setting: Medical&Surgical Department of Allied, DHQ Hospital & Nawaz Medicare Faisalabad. Period: FromJan 2000 to Nov 2000 Patients & Methods: Fifty diabetic patients with foot infections were included in this study. Themean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups(Group A and Group B).Results: The male patients were 41(82%) and female 9(18%). Forty six percent of patients were on oral hypoglycaemicdrugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheralvascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF ( Neupogen )therapy (n=25) subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group Breceived only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy wasassociated with earlier eradication of pathogens from the infected ulcer (median 5 [range 2-11] vs11 [6-31] days in thegroup B; (p=<O.000I), quicker resolution of cellulitis (6 vs l4 days; p<O.0001), shorter hospital stay (8 vsl6 days;p<O.000l), and a shorter duration of intravenous antibiotic treatment (7 vs l4 days ;p—0.0001).No G-CSF treatedpatient needed surgery, whereas three patients in group B underwent toe amputation and six had extensivedebridement under anaesthesia (p=0.00 1). G-CSF therapy was generally well tolerated. Conclusion: Granulocytecolony stimulating factor (G-CSF) may be used as a good adjuvant therapy along with conventional measures for themanagement of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequentlyprevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibioticuse and last but not the least the total misery of the patients.

Osteomyelitis, diabetic foot ulcers and the role of the community nurse

2021 ◽  
Vol 26 (Sup6) ◽  
pp. S6-S9
Author(s):  
Melanie Lumbers
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Holistic Approach ◽  
Diabetic Patients ◽  
Positive Outcomes ◽  
Community Nurse ◽  
Complex Needs ◽  
Health And Wellbeing

Community nurses face numerous challenges in both diagnosing and effectively treating their patients. The diabetic patient has complex needs requiring a holistic approach. With a reported increase in diabetic patients, and a possible decline in some routine screening following Covid-19 pandemic, complications in diabetic patients are likely to rise. It is estimated that 25% of diabetic patients will develop a diabetic foot ulcer (DFU), with a reported 43% of DFU already infected at first presentation to a health professional. NICE categorise the level of infection in DFU based on standardised assessments such as SINBAD. A high categorised DFU has the possibility of osteomyelitis. It is imperative that osteomyelitis is treated immediately to achieve positive outcomes, benefitting the patients' health and wellbeing in addition to reducing the financial implications to the NHS.

scholarly journals The risks and external effects of diabetic foot ulcer on diabetic patients: A hospital-based survey in Wuhan area, China

2017 ◽  
Vol 25 (5) ◽  
pp. 858-863 ◽  
Author(s):  
Aimei Zhong ◽  
Gongchi Li ◽  
Dan Wang ◽  
Yi Sun ◽  
Xinghua Zou ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
External Effects ◽  
Wuhan Area

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

scholarly journals A Rare Form of Melanoma Masquerading as a Diabetic Foot Ulcer: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Susan Thomas ◽  
Yuan-Xiang Meng ◽  
Vijaykumar G. Patel ◽  
Gregory Strayhorn
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Primary Care Clinic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Acral Lentiginous Melanoma ◽  
Diabetic Ulcer ◽  
Formidable Challenge

Background. Acral lentiginous melanoma (ALM) is a less-common form of melanoma in US, and it accounts for about 5% of all diagnosed melanomas in US. ALM is often overlooked until it is well advanced because of the lesion’s location and its atypical appearance in the early stages. We present a case of ALM initially presented as a diabetic foot ulcer.Case Report. An 81-year-old man initially presented to the primary care clinic with a right foot diabetic ulcer. There was a large plantar, dark-colored ulcer that bled easy. Initial excision biopsy revealed Clark’s Level IV ALM. Subsequent definitive wide excision and sentinel node biopsy confirmed ALM with metastasis to inguinal lymph nodes (stage IIIb). The treatment included wide margin excision of the lesion with en bloc amputations of 4th and 5th toes, followed by adjuvant chemotherapy.Discussion. The development of ALM may potentially relate to diabetes as a reported higher prevalence of diabetes with ALM patients.Conclusion. The difficulty in early diagnosing of ALM remains as a formidable challenge particularly in diabetic patients who commonly develop plantar foot ulcers due to the diabetic neuropathy. This case reiterates the importance of a thorough foot exam in such patients.

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

scholarly journals Clinical Profile of Patients with Diabetic Foot Ulcer Treated Conservatively or Surgically and Effect of Risk Factors on Ulcer Healing

2021 ◽  
Vol 8 (6) ◽  
pp. 238-244
Author(s):  
Ved Prakash
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Glycemic Control ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Clinical Profile ◽  
Diabetic Patients ◽  
Duration Of Diabetes

Objective: The aim of this study was to assess the clinical profile of patients with diabetic foot ulcer treated conservatively or surgically and effect of risk factors on ulcer healing. Methods: This was a retrospective observational study conducted in tertiary medical teaching hospital where medical records of diabetic patients who were admitted with foot problem were evaluated. All diabetic patients who were aged >18 years and admitted with DFU were included in this study. A structured proforma was used to collect data from the medical record. SPSS version 20.0 was used to perform the statistical analysis. Result: 280 subjects with diabetic foot ulcer (DFU) were evaluated in this study. 71% ulcers were healed where as 11% were persisted unhealed. Patients who were undergone for amputation 12% were minor (Foot only) and 4% were major (above the ankle). A statistically significant association between age, duration of diabetes, glycemic control peripheral neuropathy, and ulcer size were found with diabetic foot ulcer healing. Conclusion: Modifiable factors like good glycemic control, early management of ulcers and early treatment of peripheral neuropathy can influence Diabetic foot ulcer outcomes. Special care should be provided to diabetic subjects who are aged and have longer duration of diabetes. Keywords: Diabetic foot ulcers, ulcer severity, clinical profile, Wagner’s Classification, outcome.

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