Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Export

@article{citeulike:4081754, abstract = {OBJECTIVE: To validate a wound classification instrument that includes assessment of depth, infection, and ischemia based on the eventual outcome of the wound. RESEARCH DESIGN AND METHODS: We evaluated the medical records of 360 diabetic patients presenting for care of foot wounds at a multidisciplinary tertiary care foot clinic. As per protocol, all patients had a standardized evaluation to assess wound depth, sensory neuropathy, vascular insufficiency, and infection. Patients were assessed at 6 months after their initial evaluation to see whether an amputation had been performed. RESULTS: There was a significant overall trend toward increased prevalence of amputations as wounds increased in both depth (chi 2trend = 143.1, P < 0.001) and stage (chi 2trend = 91.0, P < 0.001). This was true for every subcategory as well with the exception of noninfected, nonischemic ulcers. There were no amputations performed within this stage during the follow-up period. Patients were more than 11 times more likely to receive a midfoot or higher level amputation if their wound probed to bone (18.3 vs. 2.0\%, P < 0.001, chi 2 = 31.5, odds ratio (OR) = 11.1, CI = 4.0-30.3). Patients with infection and ischemia were nearly 90 times more likely to receive a midfoot or higher amputation compared with patients in less advanced wound stages (76.5 vs. 3.5\%, P < 0.001, chi 2 = 133.5, OR = 89.6, CI = 25-316). CONCLUSIONS: Outcomes deteriorated with increasing grade and stage of wounds when measured using the University of Texas Wound Classification System.}, author = {Armstrong, D. G. and Lavery, L. A. and Harkless, L. B.}, citeulike-article-id = {4081754}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/9589255}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=9589255}, issn = {0149-5992}, journal = {Diabetes care}, keywords = {dfi}, month = {May}, number = {5}, pages = {855--859}, posted-at = {2009-02-23 01:59:58}, priority = {2}, title = {Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/9589255}, volume = {21}, year = {1998} }

TY - JOUR ID - citeulike:4081754 L3 - citeulike-article-id:4081754 N2 - OBJECTIVE: To validate a wound classification instrument that includes assessment of depth, infection, and ischemia based on the eventual outcome of the wound. RESEARCH DESIGN AND METHODS: We evaluated the medical records of 360 diabetic patients presenting for care of foot wounds at a multidisciplinary tertiary care foot clinic. As per protocol, all patients had a standardized evaluation to assess wound depth, sensory neuropathy, vascular insufficiency, and infection. Patients were assessed at 6 months after their initial evaluation to see whether an amputation had been performed. RESULTS: There was a significant overall trend toward increased prevalence of amputations as wounds increased in both depth (chi 2trend = 143.1, P < 0.001) and stage (chi 2trend = 91.0, P < 0.001). This was true for every subcategory as well with the exception of noninfected, nonischemic ulcers. There were no amputations performed within this stage during the follow-up period. Patients were more than 11 times more likely to receive a midfoot or higher level amputation if their wound probed to bone (18.3 vs. 2.0%, P < 0.001, chi 2 = 31.5, odds ratio (OR) = 11.1, CI = 4.0-30.3). Patients with infection and ischemia were nearly 90 times more likely to receive a midfoot or higher amputation compared with patients in less advanced wound stages (76.5 vs. 3.5%, P < 0.001, chi 2 = 133.5, OR = 89.6, CI = 25-316). CONCLUSIONS: Outcomes deteriorated with increasing grade and stage of wounds when measured using the University of Texas Wound Classification System. IS - 5 JF - Diabetes care SN - 0149-5992 EP - 859 TI - Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. VL - 21 SP - 855 KW - dfi AU - Armstrong, DG AU - Lavery, LA AU - Harkless, LB PY - 1998/05// UR - http://view.ncbi.nlm.nih.gov/pubmed/9589255 ER -