Chuan et al developed the Perfusion, Extent, Depth, Infection and Sensation (PEDIS) Classification Scale and Score for evaluating patients with a diabetic foot ulcer. This can help to identify a patient who may benefit from more aggressive management. The authors are from the First Affiliated Hospital of Chong1ing Medical University in China.
Patient selection: diabetic foot ulcer
Adverse outcomes: failure to heal, amputation, death
Parameters:
(1) perfusion (P)
(2) extent (E)
(3) depth (D)
(4) infection (I)
(5) sensation (S)
Items are graded from 1 to 4. The point assignment is the grade minus 1.
|
Parameter |
Finding |
Points |
|
Perfusion |
no PAD |
0 |
|
|
PAD without critical limb ischemia (CLI) |
1 |
|
|
critical limb ischemia |
2 |
|
Extent |
skin intact |
0 |
|
|
< 1 square cm |
1 |
|
|
1 to 3 square cm |
2 |
|
|
> 3 square cm |
3 |
|
Depth |
skin intact |
0 |
|
|
surface (superficial) |
1 |
|
|
fascia, muscle, tendon (deep) |
2 |
|
|
bone or joint |
3 |
|
Infection |
none |
0 |
|
|
surface (superficial) |
1 |
|
|
abscess, fasciitis, septic arthritis (deep) |
2 |
|
|
SIRS, sepsis |
3 |
|
sensation |
no loss |
0 |
|
|
loss |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the worse the clinical outcome.
Performance:
• The sensitivity for adverse outcomes was 93% and specificity 82%.
• The area under the ROC curve was 0.95.
Specialty: Dermatology, Endocrinology, Surgery, general, Surgery, orthopedic
