Author(s): Lavery LA, Peters EJ, Williams JR, Murdoch DP, Hudson A,
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Abstract 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 (chi(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.
This article was published in Diabetes Care
and referenced in Journal of Clinical Case Reports