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Predictors of Lipsky et al for Treatment Failure in a Patient with a Diabetic Foot Infection

Description

Lipsky et al identified factors predictive of treatment failure in a patient with a diabetic foot infection. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Washington in Seattle, Mount Sinair School of Medicine in New York City, Rosalind Franklin University in Chicago, University of Hawaii and Merck & Company.


 

Patient selection: diabetic foot infection

 

Outcome: treatment failure

 

Predictors of treatment failure from multivariate analysis:

(1) Grade 2 or 3 in the University of Texas diabetic wound classification (“severe”)

(2) elevated baseline white blood cell count per µL

 

WBC count

Failure rate

< 2,298 per µL

< 1%

2,298 to 5,268

5%

5,269 to 8,239

10%

8,240 to 11,210

17%

11,211 to 14, 181

22%

>= 14,182 per µL

46%

 

where:

• Absolute neutropenia would probably be associated with failure but may not have been represented in the study population.

 

The mean WBC count was 8,239 per µL with 1 standard deviation 2,971. One SD above the mean was 11,211 per µL.

Number of Predictors

Failure Rate

0

10%

1

16-17%

2

46%

 


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