The Infected Diabetic Foot: Risk Factors for Re-Infection After Treatment for Diabetic Foot Osteomyelitis

Authors

Lawrence A Lavery
Mario C Reyes
Bijan Najafi
Tyler L Coye
Matthew Sideman
Michael C Siah
Arthur N Tarricone

Language

English

Publication Date

1-1-2025

Journal

Wound Repair and Regeneration

DOI

10.1111/wrr.13246

PMID

39835482

PMCID

PMC11748103

PubMedCentral® Posted Date

1-21-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Our objective was to evaluate risk factors for re-infection in patients after treatment for diabetic foot osteomyelitis (OM). We used pooled patient level data from two RTCs that evaluated patients with diabetic foot infections. We evaluated 171 patients with OM. OM was confirmed with bone culture or histopathology. Data from the 12-month follow-up were used to determine clinical outcomes. Re-infection occurred in 47 (27.5%) patients. Risk factors for re-infection were Toe Brachial Index < 0.40 (25.7% vs. 9.8%, p = 0.02), skin perfusion pressure < 40 mmHg (6.3% vs. 5.9%, p = 0.04), wound healing (55.3% vs. 75.0%, p = 0.01), time to heal (156.0, 69.5-365 vs. 91.5, 38.8-365, p = 0.001), and history of MI (14.9% vs. 3.2%, p = 0.005). During 12-month follow-up, patients with re-infections were 198.8 times more likely to require a foot related hospitalisation (81.8% vs. 0.0%, p = 0.001), 10.4 times more likely have an all-cause hospitalisation (70.2% vs. 18.5%, p = 0.001) and 9.4 times more likely to need an amputation (36.2% vs. 5.6%, p = 0.001). Patients with re-infection had a significantly longer median length of hospitalisation (20.0, 13.5-34.5 vs. 14.0, 10.0-22.0, p = 0.003) and median length of antibiotic duration (55.0, 35.0-87.0 vs. 46.0, 22.8-68.0, p = 0.03). Patients with re-infection are less likely to heal and have more foot-related hospitalizations and amputations.

Keywords

Humans, Diabetic Foot, Osteomyelitis, Male, Female, Risk Factors, Middle Aged, Wound Healing, Aged, Anti-Bacterial Agents, Amputation, Surgical, Follow-Up Studies, Reinfection, Debridement, amputation, diabetes, infection, osteomyelitis, ulcer

Published Open-Access

yes

Recommended Citation

Lavery, Lawrence A; Reyes, Mario C; Najafi, Bijan; et al., "The Infected Diabetic Foot: Risk Factors for Re-Infection After Treatment for Diabetic Foot Osteomyelitis" (2025). Huffington Center on Aging Staff Publications. 61.
https://digitalcommons.library.tmc.edu/aging_research/61