Nomogram analysis of the influencing factors of diabetic foot in patients with diabetes mellitus.

PURPOSE

To explore the influencing factors of diabetic foot (DF) in diabetic patients and evaluate the influencing factors.

METHODS

All 674 diabetic patients admitted to our hospital from January 2015 to June 2019 who met the research criteria were included as study subjects. Clinical data were collected retrospectively by filling in the case report form for clinical research, including the general demographic characteristics, disease history, laboratory examination results, and incidence of diabetes-related complications. Logistic regression analysis was used to screen the factors influencing DF: the nomogram method was applied to score the factors, and a scoring model was constructed.

RESULTS

A total of 122 patients (18.1%) with newly diagnosed DF were identified. Multivariate analysis showed that long duration of diabetes (OR = 2.355), complicated diabetic nephropathy (OR = 3.073), and high HbA1c levels (OR = 1.885) were risk factors for DF development and that foot care education (OR = 0.473) was a protective factor. Cox proportional risk model analysis showed that, compared to patients with better control of HbA1C, the hazard ratio (HR) of DF in the HbA1 group, HbA2 group, and HbA3 group was 1.25, 1.58, and 4.71, respectively. Nomogram model analysis showed that the total score of each factor ranged from 44 to 176 points, and the corresponding risk rate ranged from 0.10 to 0.90 points. The higher the total score, the greater the risk of DF in diabetic patients; the area under the curve in the nomogram model was 0.742; 95% CI: 0.665~0.820 (P < 0.0001).

CONCLUSION

The key to preventing DF is to enhance diabetic patients' education regarding DF care, improve patients' self-management abilities, and improve patients' blood glucose control.