Bravo-Molina Alejandra, Linares-Palomino José Patricio, Vera-Arroyo Blanca, Salmerón-Febres Luis Miguel, Ros-Díe Eduardo
Unidad de Angiología y Cirugía Vascular, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Unidad de Angiología y Cirugía Vascular, Complejo Hospitalario Universitario de Granada, Granada, Spain.
Foot Ankle Surg. 2018 Feb;24(1):60-64. doi: 10.1016/j.fas.2016.10.009. Epub 2016 Dec 7.
The aim of this cohort study was to assess the inter-observer agreement of three diabetic foot classification systems: the Wagner, the University of Texas and the PEDIS.
We included 250 consecutive patients diagnosed of diabetic foot syndrome in 2009-2013. Wound scores were recorded at admission and a reevaluation was performed simultaneously or 24h later by a different evaluator. Demographical, laboratory data and associated risk factors were obtained from the patients' medical records.
The Kappa coefficient showed a moderate inter-observer agreement between the first evaluation and the reevaluation for Wagner scale (Kappa=0.55; 95% CI: 0.507-0.593), University of Texas scale (Kappa=0.513; 95% CI: 0.463-0.563) and for PEDIS scale (Kappa=0.574; 95% CI: 0.522-0.626).
This moderate agreement shows that these scales should not be used alone for management decisions regarding diabetic foot syndrome and should, therefore, be integrated with other clinical data to ensure an adequate handover.
本队列研究的目的是评估三种糖尿病足分类系统（瓦格纳、德克萨斯大学和PEDIS）观察者间的一致性。
我们纳入了2009年至2013年连续诊断为糖尿病足综合征的250例患者。入院时记录伤口评分，并由另一名评估者在同时或24小时后进行重新评估。从患者病历中获取人口统计学、实验室数据和相关危险因素。
卡帕系数显示，瓦格纳量表（卡帕=0.55；95%可信区间：0.507-0.593）、德克萨斯大学量表（卡帕=0.513；95%可信区间：0.463-0.563）和PEDIS量表（卡帕=0.574；95%可信区间：0.522-0.626）在首次评估和重新评估之间观察者间一致性为中等。
这种中等程度的一致性表明，这些量表不应单独用于糖尿病足综合征的管理决策，因此，应与其他临床数据相结合，以确保充分的交接。
