PROCALCITONIN AS BIOLOGICAL MARKER TO PREDICT THE PROGNOSIS AND FINAL OUTCOME OF DIABETIC FOOT INFECTIONS
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Abstract
Aim of the study: To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI).
Materials: 48 patients diagnosed with diabetic foot Infection and Critical Limb Ischemia (DFI and CLI). All patients were treated using a fixed protocol to salvage limb which included revascularization, wound debridement and antibiotic therapy. Procalcitonin (PCT) values were estimated and the values above 0.5 ng/ml, were considered for admission. Final outcomes of the protocol was categorized as limb salvage (discharge with preserved limb), major amputation (amputation above the ankle), and mortality.
Results: 48 patients were included belonging to both genders and aged between 45 years and 75 years. The mean age was 64.2± 06.35 years, 75% were males, and 46/48 (95.83%) of the subjects had type 2 Diabetes. The mean diabetes duration was 23.65±08.15years with a mean HbA1c of 68 ± 12 mmol/mol. 35/48 (72.91%) of patients had limb salvage, 10/48 (20.83%) had major amputation, and 03/48 (06.25%) lost their lives. 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]. Conclusions: Patients with Positive PCT at admission had increased risk of major amputations and mortality in hospital patients with DFI and CLI.
References
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Dr Pradeep VR
Assistant, Professor of General Medicine, Department of General Medicine, Kannur Medical College, Anjarakandy, Kannur, Kerala