COMPARISON OF DIFFERENT CLASSIFICATION SYSTEMS IN PREDICTING THE OUTCOME OF DIABETIC FOOT ULCERS – RESULTS OF AN OBSERVATIONAL STUDY

Aim: To compare three ulcer classification systems as predictors of the outcome of diabetic foot ulcers: University of Texas, PEDIS (perfusion, extent/size, depth/ tissue loss, infection, sensation) and IDSA (Infectious Diseases Society of America) infection grading system. Material and methods: Ulcer area, depth, appearance, infection and associated ischemia and neuropathy were recorded in a consecutive series of 150 subjects hospitalized with foot ulcer between January 2014 and June 2016. Presence of osteolysis was assessed by foot X-ray. Results: Mean age of the study patients was 60.67 years; 101 (68.2%) were male. Most ulcers (75.7%) were treated conservatively, while 36 (24.3%) subjects underwent amputation. Significant differences between patients with amputation and those conservatively treated were observed with regard to depth (p<0.001) and extent of lesions (p<0.001) using the PEDIS system, Texas grade (p=0.005) and IDSA infection severity (p<0.001). All three classification systems predicted ulcer outcome (p<0.001). No differences were found between these three classifications in terms of predicting amputations in our study groupː PEDIS–ISDA (p=0.53), PEDIS–TEXAS (p=0.78) IDSA–TEXAS (p=0.62). Conclusions: All three systems predicted ulcer outcome, without obvious benefits of using a particular classification.