Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection
Aim. To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI). Materials and Methods. The study group was composed of diabetic patients with DFI and CLI. All patients were treated according to a preset limb salvage protoco...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/4312737 |
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| author | Marco Meloni Valentina Izzo Laura Giurato Enrico Brocco Michele Ferrannini Roberto Gandini Luigi Uccioli |
| author_facet | Marco Meloni Valentina Izzo Laura Giurato Enrico Brocco Michele Ferrannini Roberto Gandini Luigi Uccioli |
| author_sort | Marco Meloni |
| collection | DOAJ |
| description | Aim. To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI). Materials and Methods. The study group was composed of diabetic patients with DFI and CLI. All patients were treated according to a preset limb salvage protocol which includes revascularization, wound debridement, antibiotic therapy, and offloading. Inflammatory markers, including PCT, were evaluated at admission. Only positive values of PCT, greater than 0.5 ng/ml, were considered. Hospital outcomes were categorized as limb salvage (discharge with preserved limb), major amputation (amputation above the ankle), and mortality. Results. Eighty-six patients were included. The mean age was 67.3±11.4 years, 80.7% were male, 95.1% had type 2 diabetes, and the mean diabetes duration was 20.5±11.1 with a mean HbA1c of 67±16 mmol/mol. 66/86 (76.8%) of patients had limb salvage, 7/86 (8.1%) had major amputation, and 13/86 (15.1%) died. Patients with positive PCT baseline values in comparison to those with normal values showed a lower rate of limb salvage (30.4 versus 93.6%, p=0.0001), a higher rate of major amputation (13 versus 6.3%, p=0.3), and a higher rate of hospital mortality (56.5 versus 0%, p<0.0001). At the multivariate analysis of independent predictors found at univariate analysis, positive PCT was an independent predictor of major amputation [OR 3.3 (CI 95% 2.0-5.3), p=0.0001] and mortality [OR 4.1 (CI 95% 2.2-8.3), p<0.0001]. Discussion. Positive PCT at admission increased the risk of major amputation and mortality in hospital patients with DFI and CLI. |
| format | Article |
| id | doaj-art-90faf1f51aa74fe283bcc0ae88f2193f |
| institution | DOAJ |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Journal of Diabetes Research |
| spelling | doaj-art-90faf1f51aa74fe283bcc0ae88f2193f2025-08-20T03:20:32ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/43127374312737Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot InfectionMarco Meloni0Valentina Izzo1Laura Giurato2Enrico Brocco3Michele Ferrannini4Roberto Gandini5Luigi Uccioli6Diabetic Foot Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyDiabetic Foot Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyDiabetic Foot Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyDiabetic Foot Unit, Foot and Ankle Clinic, Abano Terme Polyclinic, Piazza Cristoforo Colombo 1, 35031, Abano Terme, Padua, ItalyDivision of Hypertension and Nephrology, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyDepartment of Interventional Radiology, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyDiabetic Foot Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, ItalyAim. To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI). Materials and Methods. The study group was composed of diabetic patients with DFI and CLI. All patients were treated according to a preset limb salvage protocol which includes revascularization, wound debridement, antibiotic therapy, and offloading. Inflammatory markers, including PCT, were evaluated at admission. Only positive values of PCT, greater than 0.5 ng/ml, were considered. Hospital outcomes were categorized as limb salvage (discharge with preserved limb), major amputation (amputation above the ankle), and mortality. Results. Eighty-six patients were included. The mean age was 67.3±11.4 years, 80.7% were male, 95.1% had type 2 diabetes, and the mean diabetes duration was 20.5±11.1 with a mean HbA1c of 67±16 mmol/mol. 66/86 (76.8%) of patients had limb salvage, 7/86 (8.1%) had major amputation, and 13/86 (15.1%) died. Patients with positive PCT baseline values in comparison to those with normal values showed a lower rate of limb salvage (30.4 versus 93.6%, p=0.0001), a higher rate of major amputation (13 versus 6.3%, p=0.3), and a higher rate of hospital mortality (56.5 versus 0%, p<0.0001). At the multivariate analysis of independent predictors found at univariate analysis, positive PCT was an independent predictor of major amputation [OR 3.3 (CI 95% 2.0-5.3), p=0.0001] and mortality [OR 4.1 (CI 95% 2.2-8.3), p<0.0001]. Discussion. Positive PCT at admission increased the risk of major amputation and mortality in hospital patients with DFI and CLI.http://dx.doi.org/10.1155/2019/4312737 |
| spellingShingle | Marco Meloni Valentina Izzo Laura Giurato Enrico Brocco Michele Ferrannini Roberto Gandini Luigi Uccioli Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection Journal of Diabetes Research |
| title | Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection |
| title_full | Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection |
| title_fullStr | Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection |
| title_full_unstemmed | Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection |
| title_short | Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection |
| title_sort | procalcitonin is a prognostic marker of hospital outcomes in patients with critical limb ischemia and diabetic foot infection |
| url | http://dx.doi.org/10.1155/2019/4312737 |
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