Reevaluating the way we classify the diabetic foot: restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot

International Working Group on the Diabetic Foot

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)154-6
Number of pages3
JournalDiabetes Care
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 2008

Cite this

@article{66437fd601dd461f94b7d08e6d3dbc5f,
title = "Reevaluating the way we classify the diabetic foot: restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot",
abstract = "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.",
keywords = "Amputation/statistics & numerical data, Arterial Occlusive Diseases/physiopathology, Diabetic Angiopathies/physiopathology, Diabetic Foot/classification, Foot Ulcer/epidemiology, Humans, Risk Assessment, Risk Factors",
author = "Lavery, {Lawrence A} and Peters, {Edgar J G} and Williams, {Jayme R} and Murdoch, {Douglas P} and Amanda Hudson and Lavery, {David C} and {International Working Group on the Diabetic Foot}",
year = "2008",
month = "1",
doi = "10.2337/dc07-1302",
language = "English",
volume = "31",
pages = "154--6",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association Inc.",
number = "1",

}

Reevaluating the way we classify the diabetic foot : restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot. / International Working Group on the Diabetic Foot.

In: Diabetes Care, Vol. 31, No. 1, 01.2008, p. 154-6.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Reevaluating the way we classify the diabetic foot

T2 - restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot

AU - Lavery, Lawrence A

AU - Peters, Edgar J G

AU - Williams, Jayme R

AU - Murdoch, Douglas P

AU - Hudson, Amanda

AU - Lavery, David C

AU - International Working Group on the Diabetic Foot

PY - 2008/1

Y1 - 2008/1

N2 - 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.

AB - 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.

KW - Amputation/statistics & numerical data

KW - Arterial Occlusive Diseases/physiopathology

KW - Diabetic Angiopathies/physiopathology

KW - Diabetic Foot/classification

KW - Foot Ulcer/epidemiology

KW - Humans

KW - Risk Assessment

KW - Risk Factors

U2 - 10.2337/dc07-1302

DO - 10.2337/dc07-1302

M3 - Article

VL - 31

SP - 154

EP - 156

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 1

ER -