Risk prediction models for foot ulcer recurrence in diabetic patients: a systematic review
10.3760/cma.j.cn115682-20240311-01242
- VernacularTitle:糖尿病患者足溃疡复发风险预测模型的系统评价
- Author:
Miaomiao ZHANG
1
;
Xiaoyun WANG
;
Tingyuan KOU
Author Information
1. 山西医科大学护理学院，太原 030001
- Keywords:
Diabetic foot;
Ulcer;
Recurrence;
Predictive model;
Systematic review
- From:
Chinese Journal of Modern Nursing
2024;30(30):4134-4143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the risk prediction model of diabetic foot ulcer (DFU) recurrence, so as to provide theoretical guidance for the prevention of DFU recurrence.Methods:The literature on DFU risk prediction models was systematically searched on the Web of Science, Embase, PubMed, CINAHL, Cochrane Library, China Biology Medicine, CNKI, VIP, WanFang Data, and the citations and references of the included literature were traced back. The search period was from the establishment of the database to March 1, 2024, and the search language was not limited. Two researchers independently conducted literature screening and data extraction, and evaluated the quality of the included studies using the predictive model bias risk assessment tool.Results:A total of 12 articles were included, involving 18 prediction models, with a sample size ranging from 101 to 1 333 cases and a number of outcome events ranging from 29 to 209. The predictive factors with the high number of repeated model reports were ulcer location ( n=9), smoking history ( n=8), gender ( n=6), amputation history ( n=6), glycated hemoglobin ( n=5), and body mass index ( n=5). The area under the receiver operating characteristic curve reported by 18 models ranged from 0.660 to 0.943. Nine articles underwent internal validation, and five articles underwent a combination of internal and external validation. These 18 prediction models had good applicability, but there was a high risk of bias, mainly concentrated in data analysis. Conclusions:Special attention should be paid to male DFU patients with foot ulcers and a history of smoking. The included model has good predictive performance and applicability, which helps medical and nursing staff identify high-risk patients for DFU recurrence early. Extensive and in-depth validation can be conducted on existing models, or prospective studies with multiple centers and large samples can be conducted to reduce bias and continuously optimize the model, thereby serving clinical practice well.
