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Volume 8
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10.3390/jcm8101538
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Article

Diabetic Foot Infection Presenting Systemic Inflammatory Response Syndrome: A Unique Disorder of Systemic Reaction from Infection of the Most Distal Body

by
Cheng-Wei Lin
1,
Shih-Yuan Hung
1,
Chung-Huei Huang
1,
Jiun-Ting Yeh
2 and
Yu-Yao Huang
1,3,4,*
1
Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
2
Department of Plastic surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
3
College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
4
Department of Medical Nutrition Therapy, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(10), 1538; https://doi.org/10.3390/jcm8101538
Received: 14 August 2019 / Revised: 21 September 2019 / Accepted: 23 September 2019 / Published: 25 September 2019
(This article belongs to the Section Endocrinology & Metabolism)
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Abstract

Diabetic foot infection (DFI) is a major complication of diabetic foot that lead to nontraumatic lower-extremity amputation (LEA). Such distal infection of the body having systemic inflammatory response syndrome (SIRS) is rarely reported. Consecutive patients treated for limb-threatening DFI in a major diabetic foot center in Taiwan were analyzed between the years 2014 to 2017. Clinical factors, laboratory data, perfusion, extent, depth, infection and sensation (PEDIS) wound score in 519 subjects with grade 3 DFI and 203 presenting SIRS (28.1%) were compared. Major LEA and in-hospital mortality were defined as poor prognosis. Patients presenting SIRS had poor prognosis compared with those with grade 3 DFI (14.3% versus 6.6% for major LEA and 6.4% versus 3.5% for in-hospital mortality). Age, wound size, and HbA1c were independent risk factors favoring SIRS presentation. Perfusion grade 3 (odds ratio 3.37, p = 0.044) and history of major adverse cardiac events (OR 2.41, p = 0.036) were the independent factors for poor prognosis in treating patients with DFI presenting SIRS. SIRS when presented in patients with DFI is not only limb- but life-threatening as well. Clinicians should be aware of the clinical factors that are prone to develop and those affecting the prognosis in treating patients with limb-threatening foot infections. View Full-Text
Keywords: diabetic foot infection; systemic inflammatory responsive syndrome; lower-extremity amputation; prognostic factors diabetic foot infection; systemic inflammatory responsive syndrome; lower-extremity amputation; prognostic factors
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MDPI and ACS Style

Lin, C.-W.; Hung, S.-Y.; Huang, C.-H.; Yeh, J.-T.; Huang, Y.-Y. Diabetic Foot Infection Presenting Systemic Inflammatory Response Syndrome: A Unique Disorder of Systemic Reaction from Infection of the Most Distal Body. J. Clin. Med. 2019, 8, 1538. https://doi.org/10.3390/jcm8101538

AMA Style

Lin C-W, Hung S-Y, Huang C-H, Yeh J-T, Huang Y-Y. Diabetic Foot Infection Presenting Systemic Inflammatory Response Syndrome: A Unique Disorder of Systemic Reaction from Infection of the Most Distal Body. Journal of Clinical Medicine. 2019; 8(10):1538. https://doi.org/10.3390/jcm8101538

Chicago/Turabian Style

Lin, Cheng-Wei, Shih-Yuan Hung, Chung-Huei Huang, Jiun-Ting Yeh, and Yu-Yao Huang. 2019. "Diabetic Foot Infection Presenting Systemic Inflammatory Response Syndrome: A Unique Disorder of Systemic Reaction from Infection of the Most Distal Body" Journal of Clinical Medicine 8, no. 10: 1538. https://doi.org/10.3390/jcm8101538

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