Lavery LA, Peters EJ, Williams JR, Murdoch DP, Hudson A, Lavery DC, International Working Group on the Diabetic Foot., et al.
Diabetes care. Date of publication 2008 Jan 1;volume 31(1):154-6.
1. Diabetes Care. 2008 Jan;31(1):154-6. Epub 2007 Oct 12.
Reevaluating the way we classify the diabetic foot: restructuring the diabetic
foot risk classification system of the International Working Group on the
Diabetic Foot.
Lavery LA(1), Peters EJ, Williams JR, Murdoch DP, Hudson A, Lavery DC;
International Working Group on the Diabetic Foot.
Author information:
(1)Department of Surgery, Texas A&M Health Science Center, Scott and White
Hospital, Temple, Texas, USA. llavery@swmail.sw.org
OBJECTIVE: To separately evaluate peripheral arterial occlusive disease (PAOD)
and foot ulcer and amputation history in a diabetic foot risk classification to
predict foot complications.
RESEARCH DESIGN AND METHODS: We evaluated 1,666 diabetic patients for 27.2 +/-
4.2 months. Patients underwent a detailed foot assessment and were followed at
regular intervals. We used a modified version of the International Working Group
on the Diabetic Foot's (IWGDF's) risk classification to assess complications
during the follow-up period.
RESULTS: There were more ulcerations, infections, amputations, and
hospitalizations as risk group increased (chi(2) for trend P < 0.001). When risk
category 2 (neuropathy and deformity and/or PAOD) was stratified by PAOD, there
were more complications in PAOD patients (P < 0.01). When risk group 3 patients
(ulceration or amputation history) were separately stratified, there were more
complications in subjects with previous amputation (P < 0.01).
CONCLUSIONS: We propose a new risk classification that predicts future foot
complications better than that currently used by the IWGDF.
DOI: 10.2337/dc07-1302
PMID: 17934155 [Indexed for MEDLINE]
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