Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients

Background. The current study analyzed the status and the factors of foot ulcers in diabetic patients and developed a nomogram and web calculator for the risk prediction model of diabetic foot ulcers. Methods. This was a prospective cohort study that used cluster sampling to enroll diabetic patients...

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Main Authors: Jing Lv, Rao Li, Li Yuan, Feng-Mei Huang, Yi Wang, Ting He, Zi-Wei Ye
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2023/1199885
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author Jing Lv
Rao Li
Li Yuan
Feng-Mei Huang
Yi Wang
Ting He
Zi-Wei Ye
author_facet Jing Lv
Rao Li
Li Yuan
Feng-Mei Huang
Yi Wang
Ting He
Zi-Wei Ye
author_sort Jing Lv
collection DOAJ
description Background. The current study analyzed the status and the factors of foot ulcers in diabetic patients and developed a nomogram and web calculator for the risk prediction model of diabetic foot ulcers. Methods. This was a prospective cohort study that used cluster sampling to enroll diabetic patients in the Department of Endocrinology and Metabolism in a tertiary hospital in Chengdu from July 2015 to February 2020. The risk factors for diabetic foot ulcers were obtained by logistic regression analysis. Nomogram and web calculator for the risk prediction model were constructed by R software. Results. The incidence of foot ulcers was 12.4% (302/2432). Logistic stepwise regression analysis showed that BMI (OR: 1.059; 95% CI 1.021-1.099), abnormal foot skin color (OR: 1.450; 95% CI 1.011-2.080), foot arterial pulse (OR: 1.488; 95% CI: 1.242-1.778), callus (OR: 2.924; 95%: CI 2.133-4.001), and history of ulcer (OR: 3.648; 95% CI: 2.133-5.191) were risk factors for foot ulcers. The nomogram and web calculator model were developed according to risk predictors. The performance of the model was tested, and the testing data were as follows: AUC (area under curve) of the primary cohort was 0.741 (95% CI: 0.7022-0.7799), and AUC of the validation cohort was 0.787 (95% CI: 0.7342-0.8407); the Brier score of the primary cohort was 0.098, and the Brier score of the validation cohort was 0.087. Conclusions. The incidence of diabetic foot ulcers was high, especially in diabetic patients with a history of foot ulcers. This study presented a nomogram and web calculator that incorporates BMI, abnormal foot skin color, foot arterial pulse, callus, and history of foot ulcers, which can be conveniently used to facilitate the individualized prediction of diabetic foot ulcers.
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spelling doaj-art-e1ae4b57b10c4cd188a6623f03a598152025-08-20T02:21:38ZengWileyJournal of Diabetes Research2314-67532023-01-01202310.1155/2023/1199885Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic PatientsJing Lv0Rao Li1Li Yuan2Feng-Mei Huang3Yi Wang4Ting He5Zi-Wei Ye6West China Hospital Endocrinology and Metabolism Department, West China School of NursingWest China Hospital Endocrinology and Metabolism Department, West China School of NursingWest China Hospital Endocrinology and Metabolism Department, West China School of NursingWest China Hospital Endocrinology and Metabolism Department, West China School of NursingWest China School of Nursing, West China Hospital Endocrinology and Metabolism DepartmentWest China School of Nursing, West China Hospital Endocrinology and Metabolism DepartmentWest China Hospital Endocrinology and Metabolism Department, West China School of NursingBackground. The current study analyzed the status and the factors of foot ulcers in diabetic patients and developed a nomogram and web calculator for the risk prediction model of diabetic foot ulcers. Methods. This was a prospective cohort study that used cluster sampling to enroll diabetic patients in the Department of Endocrinology and Metabolism in a tertiary hospital in Chengdu from July 2015 to February 2020. The risk factors for diabetic foot ulcers were obtained by logistic regression analysis. Nomogram and web calculator for the risk prediction model were constructed by R software. Results. The incidence of foot ulcers was 12.4% (302/2432). Logistic stepwise regression analysis showed that BMI (OR: 1.059; 95% CI 1.021-1.099), abnormal foot skin color (OR: 1.450; 95% CI 1.011-2.080), foot arterial pulse (OR: 1.488; 95% CI: 1.242-1.778), callus (OR: 2.924; 95%: CI 2.133-4.001), and history of ulcer (OR: 3.648; 95% CI: 2.133-5.191) were risk factors for foot ulcers. The nomogram and web calculator model were developed according to risk predictors. The performance of the model was tested, and the testing data were as follows: AUC (area under curve) of the primary cohort was 0.741 (95% CI: 0.7022-0.7799), and AUC of the validation cohort was 0.787 (95% CI: 0.7342-0.8407); the Brier score of the primary cohort was 0.098, and the Brier score of the validation cohort was 0.087. Conclusions. The incidence of diabetic foot ulcers was high, especially in diabetic patients with a history of foot ulcers. This study presented a nomogram and web calculator that incorporates BMI, abnormal foot skin color, foot arterial pulse, callus, and history of foot ulcers, which can be conveniently used to facilitate the individualized prediction of diabetic foot ulcers.http://dx.doi.org/10.1155/2023/1199885
spellingShingle Jing Lv
Rao Li
Li Yuan
Feng-Mei Huang
Yi Wang
Ting He
Zi-Wei Ye
Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
Journal of Diabetes Research
title Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
title_full Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
title_fullStr Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
title_full_unstemmed Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
title_short Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients
title_sort development and validation of a risk prediction model for foot ulcers in diabetic patients
url http://dx.doi.org/10.1155/2023/1199885
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