Endocrine Abstracts (2009) 20 P402

C-reactive protein level early after starting standard treatment of diabetic foot infection is associated with amputation risk

Baris Akinci, Serkan Yener, Sena Yesil, Nur Yapar, Yasin Kucukyavas, Abdurrahman Comlekci, Sevinc Eraslan & Firat Bayraktar


Dokuz Eylul University, Izmir, Turkey.


Prediction of amputation would aid clinicians in the management of the diabetic foot infections. We aimed to assess the predictability of baseline and early post-treatment levels of acute phase reactants on the outcome of patients with diabetic foot infections.

In this study, we included patients with infected diabetic foot ulcers who were hospitalized in Dokuz Eylul University Hospital between January 2003 and January 2008, of which data were collected prospectively during a minimum follow-up of 6 months. After exclusion of patients who underwent an urgent amputation (within 1 week of admission) and patients who did not attend the hospital for follow-up visits regularly, finally, data from 165 foot ulcer episodes were analyzed.

Univariate analysis showed that one standard deviation increase in baseline and post-treatment C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC), and one standard deviation decrease in post-treatment albumin levels were significantly associated with increased risk for amputations. Post-treatment CRP levels were more strongly related to amputations (AUC: 0.809, 0.744–0.874, 95% CI).

We suggest that CRP level obtained early after standard treatment is a strong predictor of amputation in patients with diabetic foot infections.

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