The impact and predictive value of DCSI, CRP/albumin on all-cause death in patients with diabetic foot ulcers
10.19405/j.cnki.issn1000-1492.2024.12.017
- Author:
Wei Liu
1
;
Yutong Li
1
;
Jing Qian
1
;
Zhenyi Yu
1
;
Ying Tang
1
;
Hua Ji
1
;
Mingwei Chen
1
Author Information
1. Dept of Endocrinology , The First Afiliated Hospital of Anhui Medical University , Hefei 230032
- Publication Type:Journal Article
- Keywords:
diabetic foot ulcers;
Diabetes Complications Severity Index;
C-reactive protein/albumin ratio;
mortal- ity;
all-cause death;
risk factors
- From:
Acta Universitatis Medicinalis Anhui
2024;59(12):2183-2189
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between Diabetes Complication Severity Index(DCSI), C-reactive protein/albumin ratio(CAR) and death in patients with diabetic foot ulcer(DFU) and to clarify their predictive value for all-cause death in DFU patients.
Methods:Retrospectively analyzed the clinical data of 354 DFU patients who were treated in the Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from July 2019 to December 2022. Based on survival status during follow-up, patients were divided into a survival group(n=268) and a death group(n=86). Univariate and multivariate Cox regression analyses were used to identify risk factors for all-cause death in DFU patients. Receiver operating characteristic(ROC) curves were plotted to evaluate the predictive value of DCSI, CAR, and their combination for all-cause death in DFU patients. Kaplan-Meier curves were used to explore the impact of different DCSI and CAR levels on survival in DFU patients.
Results:Univariate Cox regression analysis showed that older age, history of hypertension, higher Wagner classification levels, and elevated levels of CRP, Scr, FDP, DCSI score, and CAR were associated with a higher risk of death in DFU patients(P<0.05). Higher levels of HGB, HCT, ALB, or eGFR were associated with a lower risk of death. Patients receiving combined insulin and oral hypoglycemic medication had a lower risk of death compared to those receiving only insulin therapy(P<0.05). Multivariate Cox regression analysis indicated that older age, higher levels of Scr, DCSI, and CAR were independent risk factors for all-cause death in DFU patients, while higher levels of ALB and combined insulin and oral hypoglycemic therapy were protective factors. ROC curve analysis showed that the AUC values for DCSI, CAR, and their combination were 0.652, 0.633, and 0.686, respectively. Kaplan-Meier curve analysis revealed that patients with high DCSI scores(≥4.5) had a lower survival rate compared to those with lower DCSI scores(<4.5). Similarly, patients with high CAR levels(≥0.124) had a lower survival rate compared to those with lower CAR levels(<0.124).
Conclusion:High levels of DCSI and CAR are independent risk factors for all-cause death in DFU patients. DCSI, CAR, and their combination have predictive value for all-cause mortality in DFU patients.
- Full text:2025022716415240716DCSI、C反应蛋白_白蛋...者全因死亡的影响和预测价值_刘薇.pdf
