Diabetic foot infections and the role of Doppler USG in prognosis

Abstract

Objective: To determine the value of patient characteristics, laboratory parameters, and imaging procedures in the assessment of the severity and prognosis of diabetic foot infections (DFIs). Material and Methods: Demographic and clinical characteristics of 71 patients with DFI were evaluated retrospectively. Patient characteristics and clinical data including diabetes status and wound related information, laboratory and radiologic findings, and outcomes were recorded. Results: In patients between 35 and 60 years old, the frequency of recurrent diabetic foot infec-tions were four and half-times higher than in those over 60 years (OR 4.55, 95% CI 1.50-13.83, p= 0.007). The white blood cell count was significantly higher in severe infections (p<0.05). Gram neg-ative microorganisms were predominantly isolated from the wound cultures of patients aged be-tween 35 and 65 years (p= 0.04). Pathological findings in Doppler Ultrasonography (dUSG) was correlated with smoking (p= 0.004). There was no significant association between the severity of the wound and pathological findings in dUSG. However, presence of a pathological finding in dUSG was correlated with amputation (p=0.001). Moreover, the probability of poor outcome was four-fold higher in patients with a pathology in dUSG in the logistic regression analysis (OR 4.32, 95% CI, 1.24-14.97, p= 0.025). Conclusion: In the management of empirical therapy, gram negative mi-croorganisms should be considered, especially in patients of 35-65 years of age. Pathological find-ings in dUSG were found to be related to poor outcome such as amputation. Therefore, all patients with diabetic foot should be screened with dUSG to identify those at risk for amputation. © 2012 by Türkiye Klinikleri.