Abstract
Objective: The aim of this pilot study was to determine clinical and laboratory factors that predict amputation surgery and to evaluate the predictive value of soluble CD14 (sCD14), interleukin-6 (IL-6), and procalcitonin (PCT) in patients with diabetic foot ulcers (DFUs). Methods: Twenty-seven (20 males, 7 females) Diabetic Foot Ulcers (DFU) patients admitted to our department were consecutively enrolled. The patients’ demographics and wound characteristics were noted. IL-6, PCT, and sCD14 were measured at admission. Results: Six of the 27 patients (22%) eventually underwent lower extremity amputation. Compared to the non-amputation group, a previous history of amputation (p=0.017), the presence of gangrene (p=0.044), the Wagner grade (p=0.011), the IL-6 concentration (p=0.018), the white blood cell count (WBC) (p=0.036), and the erythrocyte sedimentation rate (ESR) (p=0.042) were significantly high in the amputation group. However, the sCD14 and PCT concentration were not significantly different. Conclusion: We have shown for the first time that IL-6 may have predictive value for lower extremity amputation in patients with DFU. Further studies are needed to confirm its predictive value in this patient group.
Highlights
Foot problems are among the most serious complications of diabetes mellitus
We found that a previous history of amputation, a higher Wagner grade, the presence of gangrene, and higher white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and IL-6 are associated with lower extremity amputation in patients with diabetic foot ulcers (DFUs)
Further studies are needed to confirm the predictive value of IL-6 for lower extremity amputation in patients with DFU
Summary
Twenty five percent of people with diabetes will develop a foot ulcer sometime during their life.[1] The annual incidence of diabetic foot ulcers (DFUs) ranges from 2% to 32%, depending on the patients’ risk category, which was previously described by the American Diabetes Association.[2,3,4] A significant number of DFUs become infected, and amputation is required in almost 20% of these patients.[5]. Proper management of DFU is crucial to reduce amputation rates in patients with diabetes. Predictive factors of limb loss in those with diabetes may help us to optimize their treatment. A number of studies have investigated clinical and laboratory findings as predictors of lower extremity amputations in patients with DFUs.[6] These factors include age, male gender, presence of gangrene, high white blood cell count (WBC), anemia, poor glycemic control, and peripheral arterial disease[6,7,8]
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