Utilize este identificador para referenciar este registo: http://hdl.handle.net/10451/32788
Título: Classification systems for lower extremity amputation prediction in subjects with active diabetic foot ulcer : a systematic review and meta-analysis
Autor: Soares, M. Monteiro
Mendes, D. Martins
Carneiro, António Vaz
Sampaio, S.
Ribeiro, M. Dinis
Palavras-chave: Clinical prediction rules
Diabetic foot
Diagnostic accuracy
Foot ulcer
Classification systems
Systematic review
Data: 2014
Editora: John Wiley and Sons
Citação: Diabetes Metab Res Rev 2014; 30: 610-622
Resumo: Aim: We systematically review the available systems used to classify diabetic foot ulcers in order to synthesize their methodological qualitative issues and accuracy to predict lower extremity amputation, as this may represent a critical point in these patients’ care. Material and Methods: Two investigators searched, in EBSCO, ISI, PubMed and SCOPUS databases, and independently selected studies published until May 2013 and reporting prognostic accuracy and/or reliability of specific systems for patients with diabetic foo t ulcer in order to predict lower extremity amputation. Results: We included 25 studies reporting a prevalence of lower extremity amputation between 6% and 78%. Eight different diabetic foot ulcer descriptions and seven prognostic stratification classification systems were addressed with a variable (1–9) number of factors included, specially peripheral arterial disease (n = 12) or infection at the ulcer site (n = 10) or ulcer depth (n = 10).The Meggitt–Wagner, S (AD)SAD and Texas University Classification systems were the most extensively validated, whereas ten classifications were derived or validated only once. Reliability was reported in a single study, and accuracy measures were reported in five studies with another eight allowing their calculation. Pooled accuracy ranged from 0.65 (for gangrene)to 0.74 (for infection).Conclusion There are numerous classification systems for diabetic foot ulcer outcome prediction, but only few studies evaluated their reliability or external validity. Studies rarely validated several systems simultaneously and only a few reported accuracy measures. Further studies assessing reliability and accuracy of the available systems and their composing variables are needed.
Descrição: Copyright © 2014 John Wiley & Sons, Ltd.
Peer review: yes
URI: http://hdl.handle.net/10451/32788
DOI: 10.1002/dmrr.2535
ISSN: 1520-7552
Versão do Editor: https://onlinelibrary.wiley.com/journal/15207560
Aparece nas colecções:FM-CEMBE-Artigos em Revistas Internacionais

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