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Clinical characteristics and outcome in 223 diabetic patients with deep foot infections

Eneroth, Magnus LU ; Apelqvist, Jan LU and Stenström, Anders LU (1997) In Foot and Ankle International 18(11). p.716-722
Abstract

Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature > 37.8°C, a sedimentation rate > 70 mm/hour, and white blood cell count (WBC) > 10 x 109/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of... (More)

Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature > 37.8°C, a sedimentation rate > 70 mm/hour, and white blood cell count (WBC) > 10 x 109/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of those unhealed at death or follow-up, 4 patients had had a major and 11 a minor amputation. After correction for age and sex, duration of diabetes < 14 years, palpable popliteal pulse, a toe pressure > 45 mmHg, and an ankle pressure > 80 mm Hg, absence of exposed bone and a white blood cell count < 12 x 109/liter were all related to healing without amputation in a logistic regression analysis. We conclude that although only 1 in 10 had a major amputation, nearly all diabetic patients with a deep foot infection needed surgery and more than one third had a minor amputation before healing or death in spite of a well- functioning diabetic foot-care team responsible for all included patients.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Foot and Ankle International
volume
18
issue
11
pages
7 pages
publisher
Williams & Wilkins
external identifiers
  • scopus:0030697966
ISSN
1071-1007
DOI
10.1177/107110079701801107
language
English
LU publication?
yes
id
24a0145f-0e6c-47a9-9538-2b5a269cfd18
date added to LUP
2017-03-29 08:55:58
date last changed
2017-07-23 05:26:35
@article{24a0145f-0e6c-47a9-9538-2b5a269cfd18,
  abstract     = {<p>Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature &gt; 37.8°C, a sedimentation rate &gt; 70 mm/hour, and white blood cell count (WBC) &gt; 10 x 10<sup>9</sup>/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of those unhealed at death or follow-up, 4 patients had had a major and 11 a minor amputation. After correction for age and sex, duration of diabetes &lt; 14 years, palpable popliteal pulse, a toe pressure &gt; 45 mmHg, and an ankle pressure &gt; 80 mm Hg, absence of exposed bone and a white blood cell count &lt; 12 x 10<sup>9</sup>/liter were all related to healing without amputation in a logistic regression analysis. We conclude that although only 1 in 10 had a major amputation, nearly all diabetic patients with a deep foot infection needed surgery and more than one third had a minor amputation before healing or death in spite of a well- functioning diabetic foot-care team responsible for all included patients.</p>},
  author       = {Eneroth, Magnus and Apelqvist, Jan and Stenström, Anders},
  issn         = {1071-1007},
  language     = {eng},
  number       = {11},
  pages        = {716--722},
  publisher    = {Williams & Wilkins},
  series       = {Foot and Ankle International},
  title        = {Clinical characteristics and outcome in 223 diabetic patients with deep foot infections},
  url          = {http://dx.doi.org/10.1177/107110079701801107},
  volume       = {18},
  year         = {1997},
}