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이은주 ( Lee Eun-Joo ) - Dong-Eui University College of Nursing
정인숙 ( Jeong Ihn-Sook ) - Pusan National University College of Nursing
우승훈 ( Woo Seung-Hun ) - Pusan National University Yangsan Hospital Department of Orthopedic Surgery
정혁재 ( Jung Hyuk-Jae ) - Pusan National University Hospital Department of Surgery
한은진 ( Han Eun-Jin ) - Severance Hospital Division of Nursing
강창완 ( Kang Chang-Wan ) - Dong-Eui University IT Convergence College of Components and Materials Engineering
현수경 ( Hyun Soo-Kyung ) - Pusan National University College of Nursing
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Abstract
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Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM).
Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients’ electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples.
Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ2 = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years.
Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.
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KeyWords
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당뇨병성 발, 발궤양, 로지스틱 모형, 위험
Diabetic Foot, Foot Ulcer, Logistic Models, Risk
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원문 및 링크아웃 정보
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등재저널 정보
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