Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review

On behalf International Working Group on the Diabetic Foot (IWGDF)

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Prediction of wound healing and major amputation in patients with diabetic foot ulceration is clinically important to stratify risk and target interventions for limb salvage. No consensus exists as to which measure of peripheral artery disease (PAD) can best predict outcomes. To evaluate the prognostic utility of index PAD measures for the prediction of healing and/or major amputation among patients with active diabetic foot ulceration, two reviewers independently screened potential studies for inclusion. Two further reviewers independently extracted study data and performed an assessment of methodological quality using the Quality in Prognostic Studies instrument. Of 9476 citations reviewed, 11 studies reporting on 9 markers of PAD met the inclusion criteria. Annualized healing rates varied from 18% to 61%; corresponding major amputation rates varied from 3% to 19%. Among 10 studies, skin perfusion pressure ≥40 mmHg, toe pressure ≥30 mmHg (and ≥45 mmHg) and transcutaneous pressure of oxygen (TcPO2) ≥25 mmHg were associated with at least a 25% higher chance of healing. Four studies evaluated PAD measures for predicting major amputation. Ankle pressure 2 appear to be more useful in predicting ulcer healing than ankle pressures or the ABI. Conversely, an ankle pressure of

Original languageEnglish (US)
Pages (from-to)128-135
Number of pages8
JournalDiabetes/Metabolism Research and Reviews
Volume32
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Foot Ulcer
Amputation
Wound Healing
Peripheral Arterial Disease
Pressure
Ankle
Diabetic Foot
Limb Salvage
Toes
Ulcer
Perfusion
Oxygen
Skin

Keywords

  • Amputation
  • Diabetes
  • Diabetic foot ulcer
  • Healing
  • Peripheral artery disease
  • Prognosis

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes : A systematic review. / On behalf International Working Group on the Diabetic Foot (IWGDF).

In: Diabetes/Metabolism Research and Reviews, Vol. 32, 01.01.2016, p. 128-135.

Research output: Contribution to journalArticle

@article{548b8df2d62c4fbd97628125dbe8f4fe,
title = "Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review",
abstract = "Prediction of wound healing and major amputation in patients with diabetic foot ulceration is clinically important to stratify risk and target interventions for limb salvage. No consensus exists as to which measure of peripheral artery disease (PAD) can best predict outcomes. To evaluate the prognostic utility of index PAD measures for the prediction of healing and/or major amputation among patients with active diabetic foot ulceration, two reviewers independently screened potential studies for inclusion. Two further reviewers independently extracted study data and performed an assessment of methodological quality using the Quality in Prognostic Studies instrument. Of 9476 citations reviewed, 11 studies reporting on 9 markers of PAD met the inclusion criteria. Annualized healing rates varied from 18{\%} to 61{\%}; corresponding major amputation rates varied from 3{\%} to 19{\%}. Among 10 studies, skin perfusion pressure ≥40 mmHg, toe pressure ≥30 mmHg (and ≥45 mmHg) and transcutaneous pressure of oxygen (TcPO2) ≥25 mmHg were associated with at least a 25{\%} higher chance of healing. Four studies evaluated PAD measures for predicting major amputation. Ankle pressure 2 appear to be more useful in predicting ulcer healing than ankle pressures or the ABI. Conversely, an ankle pressure of",
keywords = "Amputation, Diabetes, Diabetic foot ulcer, Healing, Peripheral artery disease, Prognosis",
author = "{On behalf International Working Group on the Diabetic Foot (IWGDF)} and Brownrigg, {J. R W} and Hinchliffe, {R. J.} and J. Apelqvist and Boyko, {E. J.} and R. Fitridge and Mills, {Joseph L} and J. Reekers and Shearman, {C. P.} and Zierler, {R. E.} and Schaper, {N. C.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1002/dmrr.2704",
language = "English (US)",
volume = "32",
pages = "128--135",
journal = "Diabetes/Metabolism Research and Reviews",
issn = "1520-7552",
publisher = "John Wiley and Sons Ltd",

}

TY - JOUR

T1 - Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes

T2 - A systematic review

AU - On behalf International Working Group on the Diabetic Foot (IWGDF)

AU - Brownrigg, J. R W

AU - Hinchliffe, R. J.

AU - Apelqvist, J.

AU - Boyko, E. J.

AU - Fitridge, R.

AU - Mills, Joseph L

AU - Reekers, J.

AU - Shearman, C. P.

AU - Zierler, R. E.

AU - Schaper, N. C.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Prediction of wound healing and major amputation in patients with diabetic foot ulceration is clinically important to stratify risk and target interventions for limb salvage. No consensus exists as to which measure of peripheral artery disease (PAD) can best predict outcomes. To evaluate the prognostic utility of index PAD measures for the prediction of healing and/or major amputation among patients with active diabetic foot ulceration, two reviewers independently screened potential studies for inclusion. Two further reviewers independently extracted study data and performed an assessment of methodological quality using the Quality in Prognostic Studies instrument. Of 9476 citations reviewed, 11 studies reporting on 9 markers of PAD met the inclusion criteria. Annualized healing rates varied from 18% to 61%; corresponding major amputation rates varied from 3% to 19%. Among 10 studies, skin perfusion pressure ≥40 mmHg, toe pressure ≥30 mmHg (and ≥45 mmHg) and transcutaneous pressure of oxygen (TcPO2) ≥25 mmHg were associated with at least a 25% higher chance of healing. Four studies evaluated PAD measures for predicting major amputation. Ankle pressure 2 appear to be more useful in predicting ulcer healing than ankle pressures or the ABI. Conversely, an ankle pressure of

AB - Prediction of wound healing and major amputation in patients with diabetic foot ulceration is clinically important to stratify risk and target interventions for limb salvage. No consensus exists as to which measure of peripheral artery disease (PAD) can best predict outcomes. To evaluate the prognostic utility of index PAD measures for the prediction of healing and/or major amputation among patients with active diabetic foot ulceration, two reviewers independently screened potential studies for inclusion. Two further reviewers independently extracted study data and performed an assessment of methodological quality using the Quality in Prognostic Studies instrument. Of 9476 citations reviewed, 11 studies reporting on 9 markers of PAD met the inclusion criteria. Annualized healing rates varied from 18% to 61%; corresponding major amputation rates varied from 3% to 19%. Among 10 studies, skin perfusion pressure ≥40 mmHg, toe pressure ≥30 mmHg (and ≥45 mmHg) and transcutaneous pressure of oxygen (TcPO2) ≥25 mmHg were associated with at least a 25% higher chance of healing. Four studies evaluated PAD measures for predicting major amputation. Ankle pressure 2 appear to be more useful in predicting ulcer healing than ankle pressures or the ABI. Conversely, an ankle pressure of

KW - Amputation

KW - Diabetes

KW - Diabetic foot ulcer

KW - Healing

KW - Peripheral artery disease

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=84956825369&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84956825369&partnerID=8YFLogxK

U2 - 10.1002/dmrr.2704

DO - 10.1002/dmrr.2704

M3 - Article

C2 - 26342129

AN - SCOPUS:84956825369

VL - 32

SP - 128

EP - 135

JO - Diabetes/Metabolism Research and Reviews

JF - Diabetes/Metabolism Research and Reviews

SN - 1520-7552

ER -