首页 | 本学科首页   官方微博 | 高级检索  
检索        


Erythrocyte sedimentation rate and C‐reactive protein to monitor treatment outcomes in diabetic foot osteomyelitis
Authors:Suzanne AV van Asten  Daniel C Jupiter  Moez Mithani  Javier La Fontaine  Kathryn E Davis  Lawrence A Lavery
Institution:1. Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA;2. Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands;3. Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA
Abstract:This study sought to evaluate the effectiveness of the inflammatory markers, erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP), in monitoring treatment of osteomyelitis in the diabetic foot. We screened 150 charts of patients admitted to our hospital with diabetic foot osteomyelitis (DFO), confirmed by positive results of bone culture and/or histopathology. We included patients who had an initial ESR/CRP within 72 hours of admission and two reported follow‐up values. We dichotomised patients based on the outcomes wound healing, re‐infection, recurrent ulceration, re‐hospitalisation, additional surgery, re‐amputation and death, all within 12 months, and analysed the trajectories of the markers over time. Our primary outcome, DFO remission, was defined as wound healing within 12 months of follow‐up without re‐infection. We included 122 subjects; 65 patients (53·3%) had a combination of positive culture and histopathology. Factors associated with DFO remission (n = 46) were a lower white blood count (WBC) at admission (P = 0·006) and a higher glomerular filtration rate (GFR, P = 0·049). Factors associated with healing were a lower WBC (P = 0·004), a higher GFR (P = 0·01), longer wound duration before admission (P = 0·01), location of the ulcer on the great toe (P = 0·01) and higher glycated haemoglobin (P = 0·03). Logistic regression analysis demonstrated no associations between DFO remission and other variables collected. Trajectories of the inflammatory markers showed an association between stagnating values of ESR and CRP and poor clinical outcomes. In this study population, the trajectories of both ESR and CRP during 12 months follow‐up suggest a predictive role of both inflammatory markers when monitoring treatment of DFO.
Keywords:Biomarkers  C‐reactive protein  Diabetic foot infection  Erythrocyte sedimentation rate  Osteomyelitis
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号