[Development of a Diabetic Foot Ulceration Prediction Model and Nomogram].

Area of Science:

• Diabetology
• Clinical Risk Prediction
• Public Health

Background:

• Diabetic foot ulceration (DFU) is a significant complication of diabetes mellitus (DM).
• Identifying individuals at high risk for DFU is crucial for effective prevention strategies.
• Existing prediction tools for DFU require further development and validation.

Purpose of the Study:

• To identify risk factors associated with diabetic foot ulceration (DFU).
• To develop and evaluate a predictive model and nomogram for DFU risk assessment in patients with diabetes mellitus (DM).

Main Methods:

• An unmatched case-control study involving 379 adult patients (118 with DM, 261 controls) from South Korea.
• Data collection via questionnaires, foot examinations, and electronic health records.
• Multiple logistic regression used to build the DFU prediction model and nomogram, with performance assessed by Lemeshow-Hosmer test, C-statistic, and sensitivity/specificity analyses.

Main Results:

• Key risk factors identified: previous foot ulcer/amputation, peripheral vascular disease, peripheral neuropathy, smoking, and chronic kidney disease.
• The DFU nomogram demonstrated excellent calibration (p=.321) and a high C-statistic (.95) in both training and test samples.
• High sensitivity (88.5%) and specificity (85.7%) were achieved, with better performance in males and those with DM >10 years.

Conclusions:

• The developed DFU prediction model and nomogram exhibit strong predictive performance.
• The nomogram is recommended for clinical use in monitoring DFU risk and guiding preventive interventions for individuals with diabetes mellitus.