Diabetic Neuropathic Foot Ulcers
The association of wound size, wound duration, and wound grade on healing
- David J. Margolis, MD, PHD12,
- Lynne Allen-Taylor, PHD2,
- Ole Hoffstad, MA2 and
- Jesse A. Berlin, SCD2
- 1Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
- 2Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Abstract
OBJECTIVE—The goal of this study was to evaluate whether simple risk factors can be identified that successfully characterize who will heal and who will not heal among patients who have received standard therapy for diabetic neuropathic foot ulcers.
RESEARCH DESIGN AND METHODS—For this cohort study, we evaluated >31,000 individuals with a diabetic neuropathic foot ulcer seen in the Curative Health Services System. Using multivariate logistic regression, we evaluated the association between wound size, wound duration, wound grade, and other variables and their effect on whether a patient would heal by the 20th week of care.
RESULTS—We demonstrated that wound size, wound duration, and wound grade are all significantly associated with the likelihood of a wound healing by the 20th week of care. In addition, we noted that these associations were not significantly affected by the treating wound care center, whether the unit of analysis was one wound on a patient or all of their wounds, or current adjuvant therapies.
CONCLUSIONS—We have shown that three easy-to-measure risk factors are associated with a wound healing. These results should help clinicians understand the likelihood that a wound will heal and help those conducting clinical investigations to design better trials.
- CHS, Curative Health Services
- DNFU, diabetic neuropathic foot ulcer
- GEE, generalized estimation equation
- GLLAMM, generalized linear latent and mixed model
- OR, odds ratio
Footnotes
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Address correspondence and reprint requests to David J. Margolis, MD, PhD, 815 Blockley Hall, 423 Guardian Dr., University of Pennsylvania School of Medicine, Philadelphia, PA 19104. E-mail: dmargoli{at}cceb.med.upenn.edu.
Received for publication 7 February 2002 and accepted in revised form 8 July 2002.
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- DIABETES CARE
