Saltoglu et al reported predictors for amputation and limb loss 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 multiple institutions in Turkey.
Patient selection: diabetic foot infection
Outcome: limb loss
Predictors of limb loss:
(1) male sex (OR 1.8)
(2) duration of diabetes > 20 years (OR 1.9)
(3) infected ulcer (OR 1.9), versus simple cellulitis
(4) history of peripheral vascular disease (OR 2)
(5) diabetic retinopathy (OR 2.3)
(6) ESR > 70 mm Hg (OR 1.6)
(7) infection with a Gram-negative bacteria (OR 1.8)
where:
• Serum C-reactive protein may be an alternative marker to ESR.
The risk of amputation increases with the number of risk factors:
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