Monteiro-Soares and Dinis-Ribeiro reported DIAFORA, a score for diabetic foot risk assessment. This can help to identify a patient who may require lower extremity amputation. The authors are from Oporto University in Portugal.
Patient selection: diabetic foot ulcer
Parameters:
(1) neuropathy
(2) foot deformity
(3) peripheral arterial disease
(4) previous diabetic foot ulcer (DFU) or lower extremity amputation (LEA)
(5) multiple diabetic foot ulcers
(6) infection
(7) gangrene
(8) involvement of bone
Parameter
Finding
Points
Integer Score
neuropathy
no
0
0
yes
0.75
4
foot deformity
no
0
0
yes
0.21
1
peripheral arterial disease
no
0
0
yes
1.43
7
previous DFU or LEA
no
0
0
yes
0.68
3
multiple DFU
no
0
0
yes
0.7
4
infection
no
0
0
yes
0.81
4
gangrene
no
0
0
yes
2
10
bone involvement
no
0
0
yes
1.37
7
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 0
• maximum: 7.95
Total Score
Amputation Risk Group
< 3.08
low
3.08 to 5.12
medium
> 5.12
high
Performance:
• The area under the ROC curve was 0.91.
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