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

J.R. Brownrigg, R.J. Hinchliffe, J. Apelqvist, E.J. Boyko, R. Fitridge, J.L. Mills, J. Reekers, C.P. Shearman, R.E. Zierler, N.C. Schaper, The International Working Group on the Diabetic Foot

Research output: Contribution to journalArticleAcademicpeer-review

9 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 40mmHg, toe pressure 30mmHg (and 45mmHg) and transcutaneous pressure of oxygen (TcPO2) 25mmHg were associated with at least a 25% higher chance of healing. Four studies evaluated PAD measures for predicting major amputation. Ankle pressure

Original languageEnglish
Pages (from-to)128-135
Number of pages8
JournalDiabetes/Metabolism Research and Reviews
Volume32
Issue numbersuppl. 1
Early online date5 Sep 2015
DOIs
Publication statusPublished - Jan 2016

Keywords

  • peripheral artery disease
  • diabetic foot ulcer
  • prognosis
  • diabetes
  • healing
  • amputation
  • PERIPHERAL ARTERIAL-DISEASE
  • MAJOR AMPUTATION
  • BLOOD-PRESSURE
  • SEVERITY
  • DIAGNOSIS
  • QUALITY
  • FOCUS
  • SCORE

Cite this

Brownrigg, J. R., Hinchliffe, R. J., Apelqvist, J., Boyko, E. J., Fitridge, R., Mills, J. L., Reekers, J., Shearman, C. P., Zierler, R. E., Schaper, N. C., & International Working Group on the Diabetic Foot, T. (2016). Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: a systematic review. Diabetes/Metabolism Research and Reviews, 32(suppl. 1), 128-135. https://doi.org/10.1002/dmrr.2704