Abstract: The Comorbidities and Predictive Factors for Treatment Response in Out-hospital Patients with King's Classification III Diabetes Foot Ulcers (49th Annual Conference (May 19-23, 2017))

Sunday, May 21, 2017: 8:40 AM

Chun-Lin Su, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Yun-Shing Peng, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, Chang-Cheng Chang, China Medical University Hospital, Taichung, Taiwan and Mei-Yen Chen, Chang Gung University of Science and Technology, Chiayi, Taiwan

Objective

This study is to investigate the predictive factors focused on DFU treatment response in King’s classification III.

Method

This is a prospective study included 100 patients with DFU in King’s classification III treated in out-patient clinics in Chiayi Chang Gung Memorial Hospital from 01/2011 to 12/2011. The least follow-up time was one year. Medical documentations were in respect of patients’ profiles, previous associated histories, and presence of comorbidities, follow-up time, and condition of wounds. Fisher’s exact test and one-way ANOVA was used for variables in three groups comparison, treatment success (healed or healing with wound reduction), stagnate, and failure (amputation or infection need in-hospital medical service) groups; while t-test was applied for those in two groups comparison, failure vs. non-failure and success vs. non-success groups.

Result

With the three groups stratification according to treatment response: failure (n = 8), stagnate (n = 22), and success (n = 70), rates of occurrence of retinopathy were higher in the treatment stagnate group (42.1%) than in the treatment failure (14.3%) and success group (12.5%) (p = 0.019); rates of previous PTA were higher in the treatment failure group (25%) than in the treatment stagnate (4.8%) and success group (1.5%) (p = 0.020). With two groups stratification: failure (n = 8) vs. non-failure (n = 92), and success (n = 70) vs. non-success (n = 30), previous PTA history was strongly associated with treatment failure (OR 14.33, 95% CI 1.71-120.32; P = 0,014); retinopathy (OR 0.21, 95% CI 0.07-0.65; P = 0.007) were the major negative predictors for treatment success. Gender, age, previous associated histories, CAD, CVA, ESRD and wounds condition had no statistically significant difference.

Conclusion

Previous PTA and retinopathy are major predictive factors for treatment failure or non-success, concluding that the unhealed DFU in out-patient clinics was mainly precipitated by pre-existing peripheral vascular problems.