Stephan Kress1, Helmut Anderten2, Anja Borck3, Guido Freckmann4, Lutz Heinemann5, Ulrike Holzmüller6, Bernd Kulzer7, Alexandra Portele3, Oliver Schnell8, Helga Varlemann9, Claudia Zemmrich10, Ralf Lobmann11. 1. Vinzentinus-Krankenhaus, Landau, Germany. 2. Gemeinschaftspraxis Anderten-Krok & Partner, Hildesheim, Germany. 3. Sanofi-Aventis Deutschland GmbH, Berlin, Germany. 4. Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Germany. 5. Science Consulting in Diabetes mbH, Neuss, Germany. 6. Klinik für Endokrinologie und Nephrologie der Universität Leipzig, Germany. 7. Forschungsinstitut der Diabetes Akademie Bad Mergentheim (FIDAM), Germany. 8. Sciarc GmbH, Baierbrunn, Germany. 9. Diabetologische Schwerpunktpraxis, Hamburg, Germany. 10. Praxis für Cardiovascular- und Ultraschalldiagnostik, Herz-Kreislauf-Erkrankungen und Psychotherapie, Berlin, Germany. 11. Klinik für Endokrinologie, Diabetologie und Geriatrie, Stuttgart, Germany.
Abstract
BACKGROUND: Preulcerous risk situations in patients with diabetes are often undiagnosed and care administered too late. Even with regular medical check-ups and status documentation, foot examinations have not been given enough attention. Diagnosing an individual patients' risk of developing diabetic foot ulcers may increase vigilance for diabetic foot syndrome (DFS), and the appropriate prevention measures matching the risk involved may prevent the emergence of diabetic ulcers. The classical DFS risk factors are well established and have been extensively covered in the literature; however, there is a lack of efficient screening tools that could be used for a rapid assessment of diabetic foot ulcer risk. METHODS: A methodical literature search was conducted to assess relevant publications for the preparation of a simple risk score for amputation related to diabetic foot ulcer. We then analyzed the risk factors for predictive value as odds ratios in foot ulcers and/or amputation. We used the available data to deduce a mean value to reflect the authors' consensus. RESULTS: In view of the current literature on the matter, we have developed a semi-quantitative scoring system using just a few items to allow rapid and visual risk assessment for diabetic foot ulcers alongside recommendations for prevention and a sensible follow-up strategy to match the risk. CONCLUSION: This relatively simple score enables rapid risk classification for patients that can ease the way for both physicians and patients in gaining an insight into individual risk situations. The score provides more effective preventative measures for high-risk patients against future complications.
BACKGROUND: Preulcerous risk situations in patients with diabetes are often undiagnosed and care administered too late. Even with regular medical check-ups and status documentation, foot examinations have not been given enough attention. Diagnosing an individual patients' risk of developing diabetic foot ulcers may increase vigilance for diabetic foot syndrome (DFS), and the appropriate prevention measures matching the risk involved may prevent the emergence of diabetic ulcers. The classical DFS risk factors are well established and have been extensively covered in the literature; however, there is a lack of efficient screening tools that could be used for a rapid assessment of diabetic foot ulcer risk. METHODS: A methodical literature search was conducted to assess relevant publications for the preparation of a simple risk score for amputation related to diabetic foot ulcer. We then analyzed the risk factors for predictive value as odds ratios in foot ulcers and/or amputation. We used the available data to deduce a mean value to reflect the authors' consensus. RESULTS: In view of the current literature on the matter, we have developed a semi-quantitative scoring system using just a few items to allow rapid and visual risk assessment for diabetic foot ulcers alongside recommendations for prevention and a sensible follow-up strategy to match the risk. CONCLUSION: This relatively simple score enables rapid risk classification for patients that can ease the way for both physicians and patients in gaining an insight into individual risk situations. The score provides more effective preventative measures for high-risk patients against future complications.
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