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Revista de la Sociedad Argentina de Diabetes
versión impresa ISSN 0325-5247versión On-line ISSN 2346-9420
Resumen
CARRO, Gabriela Verónica et al. Validación de clasificaciones de pie diabético en Argentina. Rev. Soc. Argent. Diabetes [online]. 2023, vol.57, n.2, pp.84-94. ISSN 0325-5247.
Introduction: the classifications of diabetic foot (DF) are a tool that aims to improve communication between professionals, referral and counter-referral, provide a prognosis, help in the assessment of lesions, and contribute to statistical purposes.
Objectives: to describe the characteristics of patients who presented to the clinic or emergency department with DF over a period of 3 months, determine the risk according to 5 classifications (Texas, IDSA, SEWSS, WIfI, and SINBAD), and evaluate their evolution at 6 months in relation to the severity degree determined by each classification.
Materials and methods: 312 patients from 15 institutions in Argentina were analyzed. The Diabetic Foot Classification Calculator/Risk Score from the Diabetic Foot Committee of the Argentina Argentina Diabetes Society was used for the analysis.
Results: 43% of patients (n=133) required hospitalization at the time of the first consultation and 61% (n=189) had previously consulted. The total major amputation percentage was 8.33% (95%CI; 5.5-11.9) (n=26), and the minor amputation percentage was 29.17% (95% CI; 24.2-34.6) (n=91). At 6 months, the death rate was 4.49% (95% CI; 2.5-7.4) (n=14), 24.3% (95% CI; 19.629.5) had an open wound (n=76), 58.0% (95% CI; 52.3-66.5) (n=181) had healed, and 7.37% were lost to follow-up (n=23). The SEWSS and WIfI classifications were related to major amputation, healing, and death. Regarding the Texas classification, 49% of patients had a penetrating wound to bone or joint (Texas 3), with or without infection. 65.3% of major amputations and 78.6% of deaths occurred in patients with ischemia. The SEWSS cut-off point for major amputation was 20.
Conclusions: knowing local data allows organizing resources to improve patient care.
Palabras clave : diabetic foot; classifications; amputation; mortality.