Predictive factors for diabetic foot ulceration: a systematic review

Diabetes/Metabolism Research and Reviews - Tập 28 Số 7 - Trang 574-600 - 2012
Matilde Monteiro‐Soares1,2, Edward J. Boyko3, Julia Turra Ribeiro1, I. Ribeiro4, Mário Dinis‐Ribeiro1
1Department of Health Information and Decision Sciences (CIDES) Center for Research in Health Technologies and Information Systems (CINTESIS), Oporto Faculty of Medicine Portugal
2Endocrinology, Diabetes and Metabolism Department – Diabetic Foot Team Centro Hospitalar de Vila Nova de Gaia/Espinho EPE Portugal
3Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs, Puget Sound Health Care System and the University of Washington, Seattle, WA, USA
4Matosinhos Local Health Unity – Atlântida Extension Portugal

Tóm tắt

SummaryImproving ability to predict and prevent diabetic foot ulceration is imperative because of the high personal and financial costs of this complication. We therefore conducted a systematic review in order to identify all studies of factors associated with DFU and assess whether available DFU risk stratification systems incorporate those factors of highest potential value.We performed a search in PubMed for studies published through April 2011 that analysed the association between independent variables and DFU. Articles were selected by two investigators‐independently and blind to each other. Divergences were solved by a third investigator.A total of 71 studies were included that evaluated the association between diabetic foot ulceration and more than 100 independent variables. The variables most frequently assessed were age, gender, diabetes duration, BMI, HbA1c and neuropathy. Diabetic foot ulceration prevalence varied greatly among studies. The majority of the identified variables were assessed by only two or fewer studies. Diabetic neuropathy, peripheral vascular disease, foot deformity and previous diabetic foot ulceration or lower extremity amputation – which are the most common variables included in risk stratification systems – were consistently associated with diabetic foot ulceration development.Existing diabetic foot ulceration risk stratification systems often include variables shown repeatedly in the literature to be strongly predictive of this outcome. Improvement of these risk classification systems though is impaired because of deficiencies noted, including a great lack of standardization in outcome definition and variable selection and measurement. Copyright © 2012 John Wiley & Sons, Ltd.

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Diabetes/Metabolism Research and Reviews

Tập 28 Số 7

574-600

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