Open AccessStratification of foot ulcer risk in patients with diabetes: a population‐based study
Author(s) -
Leese G. P.,
Reid F.,
Green V.,
Mcalpine R.,
Cunningham S.,
EmslieSmith A. M.,
Morris A. D.,
Mcmurray B.,
Connacher A. C.
Publication year - 2006
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/j.1368-5031.2006.00899.x
Subject(s) - medicine , podiatry , diabetes mellitus , observational study , confidence interval , diabetic foot , foot (prosody) , diabetic foot ulcer , type 2 diabetes , population , prospective cohort study , physical therapy , surgery , pathology , alternative medicine , linguistics , philosophy , environmental health , endocrinology
Summary This trial assessed whether a simple clinical tool can be used to stratify patients with diabetes, according to risk of developing foot ulceration. This was a prospective, observational follow‐up study of 3526 patients with diabetes (91% type 2 diabetes) attending for routine diabetes care. Mean age was 64.7 (range 15–101) years and duration of diabetes was 8.8 (±1.5 SD) years. Patients were categorised into ‘low’ (64%), ‘moderate’ (23%) or ‘high’ (13%) risk of developing foot ulcers by trained staff using five clinical criteria during routine patient care. During follow‐up (1.7 years), 166 (4.7%) patients developed an ulcer. Foot ulceration was 83 times more common in high risk and six times more in moderate risk, compared with low‐risk patients. The negative predictive value of a ‘low‐risk score’ was 99.6% (99.5–99.7%; 95% confidence interval). This clinical tool accurately predicted foot ulceration in routine practice and could be used direct scarce podiatry resources towards those at greatest need.