Evidence map›Paper›PMID 28545120›Full record

ArticlePloS one2017

Incidence and risk factors for developing infection in patients presenting with uninfected diabetic foot ulcers.

Limin Jia, Christina N Parker, Tony J Parker, Ewan M Kinnear, Patrick H Derhy, Ann M Alvarado, Flavia Huygens, Peter A Lazzarini, Diabetic Foot Working Group, Queensland Statewide Diabetes Clinical Network (Australia)

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In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Limin JiaInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Christina N ParkerInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Tony J ParkerInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Ewan M KinnearAllied Health Research Collaborative, Metro North Hospital & Health Service, Brisbane, Queensland, Australia.
Patrick H DerhyClinical Access and Redesign Unit, Queensland Health, Brisbane, Queensland, Australia.
Ann M AlvaradoInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Flavia HuygensInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Peter A LazzariniInstitute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID http://orcid.org/0000-0002-8235-7964
Diabetic Foot Working Group, Queensland Statewide Diabetes Clinical Network (Australia)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is a paucity of research on patients presenting with uninfected diabetic foot ulcers (DFU) that go on to develop infection. We aimed to investigate the incidence and risk factors for developing infection in a large regional cohort of patients presenting with uninfected DFUs.

methodsWe performed a secondary analysis of data collected from a validated prospective state-wide clinical diabetic foot database in Queensland (Australia). Patients presenting for their first visit with an uninfected DFU to a Diabetic Foot Service in one of thirteen Queensland regions between January 2012 and December 2013 were included. Socio-demographic, medical history, foot disease history, DFU characteristics and treatment variables were captured at the first visit. Patients were followed until their DFU healed, or if their DFU did not heal for 12-months, to determine if they developed a foot infection in that period.

resultsOverall, 853 patients were included; mean(standard deviation) age 62.9(12.8) years, 68.0% male, 90.9% type 2 diabetes, 13.6% indigenous Australians. Foot infection developed in 342 patients for an overall incidence of 40.1%; 32.4% incidence in DFUs healed <3 months, 55.9% in DFUs healed between 3-12 months (p<0.05). Independent risk factors (Odds Ratio (95% confidence interval)) for developing infection were: DFUs healed between 3-12 months (2.3 (1.6-3.3)), deep DFUs (2.2 (1.2-3.9)), peripheral neuropathy (1.8 (1.1-2.9)), previous DFU history (1.7 (1.2-2.4)), foot deformity (1.4 (1.0-2.0)), female gender (1.5 (1.1-2.1)) and years of age (0.98 (0.97-0.99)) (all p<0.05).

conclusionsA considerable proportion of patients presenting with an uninfected DFU will develop an infection prior to healing. To prevent infection clinicians treating patients with uninfected DFUs should be particularly vigilant with those presenting with deep DFUs, previous DFU history, peripheral neuropathy, foot deformity, younger age, female gender and DFUs that have not healed by 3 months after presentation.

Indexed as

AdultAgedAged, 80 and overAustraliaCommunicable DiseasesDiabetes Mellitus, Type 2Diabetic FootFemaleHumansIncidenceMaleMiddle AgedProspective StudiesWound Healing

Identifiers

PMID28545120
PMCPMC5435321

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.