SIRS Is Valid in Discriminating Between Severe and Moderate Diabetic Foot Infections
Open Access
- 15 October 2013
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 36 (11), 3706-3711
- https://doi.org/10.2337/dc13-1083
Abstract
OBJECTIVE: This retrospective, single-center study was designed to distinguish severe diabetic foot infection (DFI) from moderate DFI based on the presence or absence of systemic inflammatory response syndrome (SIRS). RESEARCH DESIGN AND METHODS: The database of a single academic foot and ankle program was reviewed and 119 patients were identified. Severe DFI was defined as local infection associated with manifestation of two or more objective findings of systemic toxicity using SIRS criteria. RESULTS: Patients with severe DFI experienced a 2.55-fold higher risk of any amputation (95% CI 1.21–5.36) and a 7.12-fold higher risk of major amputation (1.83–41.05) than patients with moderate DFI. The risk of minor amputations was not significantly different between the two groups (odds ratio 1.02 [95% CI 0.51–2.28]). The odds of having a severe DFI was 7.82 times higher in patients who presented with gangrene (2.03–44.81) and five times higher in patients who reported symptoms of anorexia, chills, nausea, or vomiting (2.22–11.25). The mean hospital length of stay for patients with severe DFI was ∼4 days longer than for patients with moderate DFI, and this difference was statistically significant. CONCLUSIONS: SIRS is valid in distinguishing severe from moderate DFI in hospitalized patients. Patients with severe DFI, as by manifesting two or more signs of systemic inflammation or toxicity, had higher rates of major amputation and longer hospital stays and required more surgery and more subsequent admissions than patients who did not manifest SIRS.This publication has 16 references indexed in Scilit:
- 2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot InfectionsaClinical Infectious Diseases, 2012
- Diabetic foot infections: current concept reviewDiabetic Foot & Ankle, 2012
- Etiology of Thrombocytosis in a General Medicine Population: Analysis of 801 Cases With Emphasis on Infectious CausesJournal of Clinical Medicine Research, 2012
- Surgical Treatment of Limb- and Life-Threatening Infections in the Feet of Patients With Diabetes and at Least One Palpable Pedal PulseThe International Journal of Lower Extremity Wounds, 2011
- The importance of limb preservation in the diabetic populationJournal of Diabetes and its Complications, 2011
- Management of patients hospitalized for diabetic foot infection: Results of the French OPIDIA studyDiabetes & Metabolism, 2011
- Clinical predictors of treatment failure for diabetic foot infections: data from a prospective trialInternational Wound Journal, 2007
- Diagnosis and Treatment of Diabetic Foot InfectionsClinical Infectious Diseases, 2004
- Leukocytosis is a poor indicator of acute osteomyelitis of the foot in diabetes mellitusThe Journal of Foot and Ankle Surgery, 1996
- Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in SepsisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1992