Tardivo et al reported a score for predicting amputation of a diabetic foot. It can also be used to guide patient manageemnt. The authors are from ABC Santo Andre and Universidade de Sao Paulo in Brazil.
Patient selection: diabetic foot ulcer
Parameters:
(1) Wagner grade (from 1 to 4)
(2) peripheral arterial perfusion
(3) ulcer location
Parameter
Finding
Points
Wagner grade
1 (superficial ulcer)
1
2 (deep ulcer)
2
3 (osteitis/infection)
3
4 (forefoot gangrene)
4
arterial perfusion
good
1
signs of ischemia
2
ulcer location
toes
1
metatarsals
2
midfoot
3
hindfoot
4
score =
= PRODUCT(points for the 3 parameters)
Interpretation:
• minimum score: 1
• maximum score: 32
• The higher the score the greater the risk of amputation
• The odds ratio of a score >= 12 for amputation was 152 vs a score <= 11.
To read more or access our algorithms and calculators, please log in or register.
