Diabetisches Fußsyndrom

Factors associated with diabetic foot ulcers and lower limb amputations in type 1 and type 2 diabetes supported by real‐world data from the German/Austrian DPV registry

“…Limitations include the lack of other classification systems for DFU severity that consider infection status as well, such as the University of Texas wound classification scheme (available in only ≈1% of individuals) or the SINBAD (Site, Ischemia, Bacterial infection, Area and Depth) classification which is the currently recommended classification system by the International Working Group on the Diabetic Foot. 47 Nevertheless, Wagner grades are still recommended by the German Diabetes Association 21 and therefore this is standard for centers participating in the DPV registry and used for this analysis. The self‐reported manner of the documentation of alcohol consumption and smoking behavior is also a potential bias.…”

“…Nephropathy was defined as estimated glomerular filtration rate <60 (mL/min/1.73 2 ) according to the Chronic Kidney Disease Epidemiology Collaboration formula 20 or as documented microalbuminuria or if renal transplantation or a history of dialysis was documented. For identification and classification of the severity of DFU Wagner grades were used as this classification system is still recommended in the most recent guideline on diabetic foot from the German Diabetes Association and therefore was used by the centers participating in this study during foot examinations and is included in the DPV documentation software 21 . Wagner grades range from 0 to 5 indicating no current ulcer, but pre‐ or postulcerative lesions (Wagner 0), superficial ulcer (Wagner 1), deep ulcer without abscess or bone involvement (Wagner 2), ulcer with abscess and bone involvement (Wagner 3), localized ulcer with gangrene (Wagner 4), and extensive ulcer with gangrene (Wagner 5).…”

“…For identification and classification of the severity of DFU Wagner grades were used as this classification system is still recommended in the most recent guideline on diabetic foot from the German Diabetes Association and therefore was used by the centers participating in this study during foot examinations and is included in the DPV documentation software. 21 Wagner grades range from 0 to 5 indicating no current ulcer, but pre-or postulcerative lesions (Wagner 0), superficial ulcer (Wagner 1), deep ulcer without abscess or bone T A B L E 1 Characteristics of unmatched cohort stratified by diabetic foot ulcer and amputation. involvement (Wagner 2), ulcer with abscess and bone involvement (Wagner 3), localized ulcer with gangrene (Wagner 4), and extensive ulcer with gangrene (Wagner 5).…”