Research Article
Volume 8 Issue 6 - 2021
To Predict the Risk of Lower Limb Amputation in Diabetic Foot Ulcer Patients by Using the DIAFORA Score (Diabetic Foot Risk Assessment Score)
Somya Saxena*
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
*Corresponding Author: Somya Saxena, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Received: April 04, 2021; Published: May 05, 2021


Background: A recently introduced modality is DIAFORA score, for assessing the risk of lower extremity amputation in diabetic foot ulcer patients, which is more accurate as compared to other existing classification systems.

Aims and Objective: To predict the risk of lower limb amputation in diabetic foot ulcer patients by using the DIAFORA score (Diabetic foot risk assessment score).

Materials and Methods: The study was conducted from 2018 to 2020 on a total of 50 patients with DFUs from OPD, medicine and surgery wards of the MMIMSR, Mullana. Subjects were examined and relevant investigations were sent. The DIAFORA score [3] was calculated for each patient and was categorized into one of the 3 risk groups (low, medium and high). Patients with a score less than 15 were categorized into low risk group, patients with score between 15 and 25 were categorized into medium risk group and patients with score more than 25 were categorized into high risk group for LEA and each subject was followed upto 3 months (91 days) or until LEA/death/recovery of the subject.

Result: Mean age of the patients was 55.82 ± 14.52 years. Distribution of study subjects according to the DIAFORA score into high, medium and low risk groups were 17 (34.0%), 10 (20.0%), 23 (46.0%) respectively. Mean DIAFORA score of the low risk group, medium risk group, high risk group was 7.52 ± 3.189, 22.20 ± 3.120, 33.76 ± 3.945 respectively, statistically significant (p < 0.001). DIAFORA score had Area under the receiver operating characteristic (ROC) curve 0.992 (99%) with a p value of 0.0001 (highly significant). DIAFORA score of 23 taken as cut off value for amputation had sensitivity of 91.3%, specificity of 100%, positive predictive value of 100.0% and negative predictive value of 93.1%. Amputation was done in 23 (46.0%) patients whereas rest 27 (54.0%) were recovered. In the amputation group, Peripheral neuropathy, foot deformities, Peripheral Arterial Disease, bone involvement and gangrene were present in 20 (87%),14 (60.9%), 20 (87%), 18 (78.3%), 23 (100%).

Conclusion: We conclude that the recently introduced DIAFORA score model is a reliable predictor of lower extremity amputation amongst patients with Diabetic Foot Ulcer. It has high sensitivity and specificity to predict amputation.

Keywords: DFU; LEA; DIAFORA Score; High Risk; Medium Risk; Low Risk


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Citation: Somya Saxena. “To Predict the Risk of Lower Limb Amputation in Diabetic Foot Ulcer Patients by Using the DIAFORA Score (Diabetic Foot Risk Assessment Score)” EC Gastroenterology and Digestive System 8.6 (2021): 01-07.

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