Evidence map›Paper›PMID 38982577›Full record

ArticleJournal of foot and ankle research2024

Clinical outcomes in people with diabetes-related foot infections: Analysis from a limb preservation service infection database.

Matthew Malone, Emma Bergamin, Kenshin Hayashi, Saskia Schwarzer, Hugh G Dickson, Namson Lau, Lawrence A Lavery, Robert J Commons

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In one paragraph

Article in Journal of foot and ankle research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
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

8 authors.

Matthew MaloneSouth West Sydney Limb Preservation and Wound Research, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-2946-8841
Emma BergaminSouth West Sydney Limb Preservation and Wound Research, Sydney, New South Wales, Australia.
Kenshin HayashiHigh Risk Foot Service, Liverpool Hospital, Sydney, New South Wales, Australia.
Saskia SchwarzerSouth West Sydney Limb Preservation and Wound Research, Sydney, New South Wales, Australia.
Hugh G DicksonIngham Institute of Applied Medical Research, Liverpool, New South Wales, Australia.
Namson LauIngham Institute of Applied Medical Research, Liverpool, New South Wales, Australia.
Lawrence A LaveryDepartment of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Robert J CommonsGlobal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes-related foot infections are common and represent a significant clinical challenge. There are scant data about outcomes from large cohorts. The purpose of this study was to report clinical outcomes from a large cohort of people with diabetes-related foot infections.

methodsA tertiary referral hospital limb preservation service database was established in 2018, and all new episodes of foot infections were captured prospectively using an electronic database (REDCap). People with foot infections between January 2018 and May 2023, for whom complete data were available on infection episodes, were included. Infection outcomes were compared between skin and soft tissue infections (SST-DFI) and osteomyelitis (OM) using chi-square tests.

resultsData extraction identified 647 complete DFI episodes in 397 patients. The data set was divided into two cohorts identifying each infection episode and its severity as either SST-DFI (N = 326, 50%) or OM (N = 321, 50%). Most infection presentations were classified as being moderate (PEDIS 3 = 327, 51%), with 36% mild (PEDIS 2 = 239) and 13% severe (PEDIS 4 = 81). Infection resolution occurred in 69% (n = 449) of episodes with failure in 31% (n = 198). Infection failures were more common with OM than SST-DFI (OM = 140, 71% vs. SST-DFI = 58, 29%, p < 0.00001). In patients with SST-DFI a greater number of infection failures were observed in the presence of peripheral arterial disease (PAD) compared to the patients without PAD (failure occurred in 30% (31/103) of episodes with PAD and 12% (27/223) of episodes without PAD; p < 0.001). In contrast, the number of observed infection failures in OM episodes were similar in patients with and without PAD (failure occurred in 45% (57/128) of episodes with PAD and 55% (83/193) of episodes without PAD; p = 0.78).

conclusionsThis study provides important epidemiological data on the risk of poor outcomes for DFI and factors associated with poor outcomes in an Australian setting. It highlights the association of PAD and treatment failure, reinforcing the need for early intervention to improve PAD in patients with DFI. Future randomised trials should assess the benefits of revascularisation and surgery in people with DFI and particularly those with OM where outcomes are worse.

Indexed as

Databases, FactualDiabetic FootOsteomyelitisSoft Tissue InfectionsAgedFemaleHumansLimb SalvageMaleMiddle AgedProspective StudiesTreatment Outcomediabetic foot infectionosteomyelitisoutcomesskin and soft tissue infection

Identifiers

PMID38982577
PMCPMC11633327

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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.