Reevaluating the Way We Classify the Diabetic Foot

  • Lavery L
  • Peters E
  • Williams J
  • et al.
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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 (χ2 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.

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Lavery, L. A., Peters, E. J. G., Williams, J. R., Murdoch, D. P., Hudson, A., & Lavery, D. C. (2008). Reevaluating the Way We Classify the Diabetic Foot. Diabetes Care, 31(1), 154–156. https://doi.org/10.2337/dc07-1302

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