The Efficacy of Diabetic Foot Treatment in a “TOSF” Pattern: A Five-Year Retrospective Study

Abstract

Changbao Yan,1 Sheng Wang,2 Yaoguo Yang,2 Liang Zhao,1 Jie Zhang,1 Yanyang Wang,1 Dafang Liu,1 Yihe Geng,1 Zhong Chen2 1Department of Vascular Surgery, Capital Medical University Affiliated Luhe Hospital, Beijing, People’s Republic of China; 2Department of Vascular Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, People’s Republic of ChinaCorrespondence: Zhong Chen, Tel /Fax [phone], Email [email protected]: To evaluate the advantages and problems in the diagnosis and treatment of diabetic foot (DF) patients by analyzing the results of a 5-year follow-up of the organ system based (TOSF) treatment model.Methods: A retrospective study was conducted in 229 patients with diabetic foot. Chi-square test and rank-sum test were used to analyze the effects of patients’ general condition, behavioral and nutritional status, degree of infection (inflammatory markers), comorbidity, diabetic foot grade/classification, and revascularization on readmission rate, amputation rate, all-cause mortality, incidence of other complications, and wound healing time. Logistic regression was used to analyze the risk factors affecting the prognosis of diabetic foot. Kaplan-Meier survival curve was used to analyze the differences in amputation rate and mortality rate at each time point.Results: This study showed that nutritional status, degree of infection, and revascularization influenced readmission rates. General condition, behavior and nutritional status, degree of infection, Wagner grade and revascularization affect the amputation rate. General conditions, behavioral and nutritional status, degree of infection, comorbidities, classification and revascularization affect the mortality of patients. Age and white blood cell(WBC) count affected the incidence of other complications. Influence of infection degree and Wagner grade and revascularization in patients with wound healing time. Revascularization was an independent protective factor for readmission, amputation, and mortality.Elevated serum inflammatory markers are an independent risk factor for amputation. Hypoproteinemia is an independent risk factor for mortality.Conclusion: In the “TOSF” diagnosis and treatment pattern, diabetic foot patients have a good prognosis. Special attention should be paid to the screening and revascularization of lower extremity vascular disease in patients with diabetic foot.Keywords: diabetic foot, organ system, revascularization

Keywords

• diabetic foot
• organ system
• revascularization