Development and Validation of a Risk Prediction Model for Foot Ulcers in Diabetic Patients

Area of Science:

• Endocrinology and Metabolism
• Podiatry
• Public Health

Background:

• Diabetic foot ulcers represent a significant complication of diabetes mellitus.
• High incidence rates underscore the need for effective risk prediction and prevention strategies.

Purpose of the Study:

• To analyze the prevalence and risk factors associated with diabetic foot ulcers.
• To develop and validate a predictive model (nomogram and web calculator) for diabetic foot ulcers.

Main Methods:

• Prospective cohort study involving diabetic patients from July 2015 to February 2020.
• Logistic regression analysis to identify risk factors for diabetic foot ulcers.
• Development of a nomogram and web calculator using R software for risk prediction.

Main Results:

• The incidence of diabetic foot ulcers was 12.4%.
• Key risk factors identified include BMI, abnormal foot skin color, foot arterial pulse, callus, and history of ulcer.
• The predictive model demonstrated good performance with AUC values of 0.741 and 0.787 for primary and validation cohorts, respectively.

Conclusions:

• Diabetic foot ulcer incidence is notably high, particularly in patients with a history of ulcers.
• The developed nomogram and web calculator offer a practical tool for individualized diabetic foot ulcer risk prediction.
• Incorporating BMI, skin color, pulse, callus, and ulcer history can aid in early identification and management.