Article Title:

Stratification of foot ulcer risk in patients with diabetes: a population-based study

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Int J Clin Pract. 2006 May;60(5):541-5


Leese GP, Reid F, Green V, McAlpine R, Cunningham S, Emslie-Smith AM, Morris AD, McMurray B, Connacher AC.


This trial assessed whether a simple clinical tool can be used to stratify patients with diabetes, according to developing risk of foot ulceration. This was a prospective, observational follow-up study of 3526 patients with diabets (91% typw 2 diabetes) attending for routine diabetes care. Mean age was 64.7 (range 15 - 101) years and duration was 8.8 (+/- 1.5SD) years. Patients were categorised into 'low' (64%), 'moderate' (23%) or 'high' (13%) risk of developing foot ulcers by trained staff using five clinical criteria during routine patient care. During follow-up (1.7 years), 166(4.7%) patients developed an ulcer. Foot ulceration was 83 times more common in high risk and six times more in moderate risk, compared with low risk patients. The negative predictive value of a 'low risk score' was 99.6% (99.5-99.7% confidence interval). This clinical tool accurately predicted foot ulceration in routine practice and could be used direct scarce podiatry resources to those at gretest need.

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