Probability of repetitive trauma-based ulcer recurrence in diabetic patient - Evidencio
Probability of repetitive trauma-based ulcer recurrence in diabetic patients
Recurrence of plantar foot ulcers is a common and major problem in diabetes but not well understood. This model calculates the probability of ulcer recurrence suggested to be the result of unrecognized repetitive trauma in diabetic patients.

Research authors: Waaijman R, de Haart M, Arts MLJ, Wever D, Verlouw AJW, Nollet F, and Bus SA.
Version: 1.24
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Calculated risk for repepitive trauma-based ulcer recurrence:

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Model performance:
In the original study popuation (N=171), a total of 41 (24,0%) diabetic patients had a recurrent ulcer suggested to be the result of unrecognized repetitive trauma. The optimal probability cutoff point of P = 0.063 yielded a 76% sensitivity (correctly classifying the group with ulcer recurrence) and 51% specificity (correctly classifying the group without ulcer recurrence) for this model.

Model development:
This model was based on univariate and multivariate multilevel logistic regression analysis of 41 ulcer recurrences suggested to be the result of unrecognized repetitive trauma. In the multivariate analysis, having a minor lesion at entry (OR 10.95 [95% CI 5.01–23.96]), a combination of in-shoe peak pressure <200 kPa and adherence >80% (0.43 [0.20–0.94]), a higher barefoot peak pressure (1.11 [1.00–1.22]), and more day-to-day variation in stride count (0.91 [0.86–0.96]) remained independently significantly related to ulcer recurrence.

Source:
Waaijman R, de Haart M, Arts ML, Wever D, Verlouw AJ, Nollet F, Bus SA. Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients. Diabetes Care. 2014;37(6):1697-1705.

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This algorithm is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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