Evaluation of risk factors in diabetic foot infections with systemic inflammatory response syndrome

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Objective: To explore the risk factors of systemic inflammatory response syndrome (SIRS) in diabetes foot infection (DFI). Methods: A retrospective analysis was conducted on the clinical data of 301 patients admitted to the Ninth Medical Center of the People's Liberation Army General Hospital for DFI from January 2021 to December 2023, including 223 males and 78 females with the age of (63.3±12.0) years. The study population was divided into SIRS group (n=32) and non-SIRS group (n=269) based on whether SIRS occurred. Multivariate logistic regression model was used to analyze the risk factors of DFI combined with SIRS. Results: Compared with non-SIRS group, patients in SIRS group were younger [(60.3±8.5) vs (63.7±12.3) years, P=0.047], with lower serum albumin [M(Q1, Q3)] [32.7(29.3, 37.3) vs 36.2(33.6, 39.2) g/L, P=0.003] and hemoglobin [116.0(99.8, 125.3) vs 121.0(111.0, 136.0) g/L, P=0.022], and higher glycosylated hemoglobin [9.8%(8.7%, 11.6%) vs 8.7%(7.4%, 10.6%), P=0.007]; positive rate of diabetes foot history was lower [25.0%(8/32) vs 46.8% (123/269), P=0.019] and the proportion of combined osteomyelitis was higher [90.6% (29/32) vs 46.7% (168/269), P=0.002] in SIRS group. Multivariate logistic regression analysis showed that elevated glycosylated hemoglobin (OR=1.27,95%CI:1.03-1.58) and osteomyelitis (OR=4.5,95%CI:1.20-16.86)were risk factors for SIRS. Conclusion: Poor blood glucose control and osteomyelitis are risk factors for DFI complicated with SIRS.