Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers

This study aimed to validate the association between the grades of severity of diabetic foot ulcers (DFUs) identified by the fast-tack model and specific outcomes. Three hundred and sixty-seven patients with new DFUs who were referred to a tertiary level diabetic foot service serving Rome, Italy, we...

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Detalhes bibliográficos
Autores: Meloni, Marco, Bouillet, Benjamin, Ahluwalia, Raju, Sanchez-Rios, Juan Pedro, Iacopi, Elisabetta, Izzo, Valentina, Manu, Chris, Julien, Vouillarmet, Luedmann, Claas, García Klepzig, José Luis, Guillaumat, Jérome, Lázaro Martínez, José Luis
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/125660
Acesso em linha:https://hdl.handle.net/20.500.14352/125660
Access Level:acceso abierto
Palavra-chave:616.718.7/.9
616.379-008.64
diabetes
diabetic foot
fast-track
limb salvage
wound healing
Podología
Endocrinología
3299 Otras Especialidades Médicas
3205.02 Endocrinología
Descrição
Resumo:This study aimed to validate the association between the grades of severity of diabetic foot ulcers (DFUs) identified by the fast-tack model and specific outcomes. Three hundred and sixty-seven patients with new DFUs who were referred to a tertiary level diabetic foot service serving Rome, Italy, were included. The fast-track model identifies three levels of DFUs’ severity: uncomplicated DFUs, including superficial wounds, not-infected wounds, and not-ischemic wounds; complicated DFUs, including ischemic wounds, infected wounds, and deep ulcers involving the muscles, tendons, or bones, and any kind of ulcers in patients on dialysis and/or with heart failure; and severely complicated DFUs, including abscesses, wet gangrene, necrotizing fasciitis, fever, or clinical signs of sepsis. Healing, minor and major amputation, hospitalization, and survival after 24 weeks of follow-up were considered. Among the included patients, 35 (9.6%) had uncomplicated DFUs, 210 (57.2%) had complicated DFUs, and 122 (33.2%) had severely complicated DFUs. The outcomes for patients with uncomplicated, complicated, and severely complicated DFUs were as follows, respectively: healing, 97.1%, 86.2%, and 69.8%; minor amputation, 2.9%, 20%, and 66.4%; major amputation, 0%, 2.9%, and 16.4%; hospitalization, 14.3%, 55.7%, and 89.3%; survival, 100%, 96.7%, and 89.3%. DFU severity was an independent predictor of healing, amputation, hospitalization, and survival. The current study shows an association between the grade of severity of DFUs identified by the fast-track model and the considered outcomes. The fast-track model may be a useful tool for assessing the severity and prognosis of DFUs.