Premium
The value of a wound score for diabetic foot infections in predicting treatment outcome: A prospective analysis from the SIDESTEP trial
Author(s) -
Lipsky Benjamin A.,
Polis Adam B.,
Lantz Keith C.,
Norquist Josephine M.,
Abramson Murray A.
Publication year - 2009
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1524-475x.2009.00521.x
Subject(s) - medicine , diabetic foot , cronbach's alpha , construct validity , grading (engineering) , prospective cohort study , clinical trial , foot (prosody) , physical therapy , wound infection , surgery , diabetes mellitus , psychometrics , patient satisfaction , clinical psychology , linguistics , philosophy , civil engineering , engineering , endocrinology
Scoring the severity of a diabetic foot wound infection may help assess the severity, determine the type and urgency of antibiotic and surgical treatment needed, and predict clinical outcomes. We developed a 10‐item diabetic foot infection wound score (results could range from 3 to 49 [least to most severe]) incorporating semi‐quantitative grading of both wound measurements and various infection parameters. Using data from a prospective diabetic foot infection antibiotic trial (SIDESTEP), we evaluated the score's accuracy in predicting outcome, analyzed its components and tested it for consistency, construct, and validity. Wound scores for 371 patients significantly correlated with the clinical response; it was favorable at the follow‐up assessment in 94.8% with a baseline score ≤12 compared with 77.0% with a score >19. Scores demonstrated good internal consistency (Cronbach's α >0.70 to <0.95). Patients with more severe wounds had higher scores, supporting construct validity. Excluding scores for wound discharge (purulent and nonpurulent), leaving an eight‐item score, provided better measurement statistics. This easily performed wound score appears to be a reliable, valid, and useful tool for predicting clinical outcomes. Further validation studies in different patient populations should refine the items included.