548 Diabetic Foot Burns and Amputation Rates: A Systematic Review and Meta-analysis
Notice bibliographique
Résumé
Abstract Introduction Diabetes mellitus (DM) is one of the most common chronic metabolic diseases. Comorbid peripheral neuropathy (PN) and peripheral vascular disease (PVD) puts this population at risk for foot burns and poor wound healing outcomes. There is a lack of consensus in the literature regarding the optimal approach for management of these unique injuries. The aim of this study is to systematically identify studies reporting on diabetic foot burns and critically evaluate outcomes including amputation rates among patients managed operatively versus non operatively. Methods A comprehensive search of PubMed, Embase, and Web of Science was completed. Screening was performed by two independent reviewers. Primary research studies published between 1980 to 2023 that discussed outcomes of foot burns in adult patients with DM were included. Studies that included pediatric (< 18 years old) or animal subjects, had inaccessible full texts, or were written in a language other than English were excluded. All conflicts were resolved collaboratively. The included studies were critically appraised using Newcastle-Ottawa Scale (NOS), JBI critical appraisal tool for analytical cross-sectional studies, or a published methodological tool. Results are presented using descriptive statistics of aggregated data. Results The database search yielded 2,402 non-duplicate papers, which was narrowed to 105 full texts following initial screening. A total of 35 papers met inclusion criteria, 5 of which were removed for poor scores on critical appraisal. Nine papers were included for meta-analysis, including seven retrospective comparative analyses, one cross-sectional study, and one retrospective chart review. In sum, there were 1798 diabetic foot burn patients included for analysis. Mean age was 58.2 years (SD 4.12) and 73.1% (n = 1,314) were male. A total of 15.7% (n = 283) of patients were surgically managed, which included debridement (3.7%, n = 66), grafting (8.2%, n = 147), flap (0.2%, n = 3), and primary amputation (7.1%, n = 127). Secondary amputation rate, defined as amputation following initial surgery, was 4.9%, (n = 14). The overall amputation rate of the cohort was 7.8% (n = 141). Other complications included infection (4.0%, n = 72), osteomyelitis (1.9%, n = 34), and graft failure (8.2%, n = 12). Only 1 study reported functional status at last visit. Conclusions Diabetic foot burn patients that are managed operatively experience increased morbidity including graft failure, infection, and need for additional amputation. This can have damaging effects on functional outcomes after injury. Applicability of Research to Practice The global diabetic population is growing and vulnerable to poor health outcomes, driving the need for research on diabetic foot burns to help providers reach consensus on best management practices.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,020 | 0,047 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,019 | 0,039 |
| Bibliométrie | 0,010 | 0,010 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».