The relationship between Onodera prognostic nutritional index and the severity of diabetic ulcerated foot and its predictive effect on prognosis
Objective To investigate the relationship between Onodera prognostic nutrition index(OPNI)and the severity of diabetic ulcerative foot(DFU)and its predictive effect on prognosis.Methods The clinical data of 126 DFU patients admitted to the 909th Hospital of the Joint Logistic Support Force from January 2020 to December 2021 were retrospectively analyzed.126 patients were followed up for 6 months,and were divided into a good prognosis group(ulcer healed,n=69)and a poor prognosis group(ulcer unhealed,n=57)according to the follow-up results.The relationship between OPNI and DFU ulcer severity was analyzed.Univariate and Logistic multivariate analysis were performed to analyze the influencing factors of poor prognosis of DFU,and a ROC curve was drawn to analyze the predictive effect of OPNI on prognosis of DFU.Results Among the 126 DFU patients,43,56 and 27 patients had mild,moderate,and severe lower limb ischemia respectively,and the OPNI were(46.53±1.99),(43.59±1.25)and(41.63±1.16)respectively.48,51 and 27 cases were with no or mild infec-tion,moderate infection,and severe infection respectively,and the OPNI were(46.11±2.19),(43.61±1.32)and(41.81±1.51)re-spectively.As for the Wagner grading,41,45,21 and 19 cases were graded 1 to 4 respectively,and the OPNI were(46.60±1.99),(43.88±1.08),(42.43±1.15)and(41.56±1.62)respectively.As the degree of ischemia increased,the degree of infection increased,and the higher the Wagner grade,the OPNI became lower(P＜0.05).Univariate analysis showed that glycosylated hemoglobin(HbA1c),severe lower limb ischemia,severe infection,Wagner grade(3-4),albumin(ALB),and OPNI were associated with poor prognosis of DFU.Logistic multivariate analysis found that OPNI(HR:6.462,95%CI 1.468-12.547),severe ischemia of lower limbs(HR:12.988,95%CI 2.758-28.637),severe infection(HR:11.752,95%CI 1.893-17.541)and Wagner grade(3-4)(HR:4.166,95%CI 2.663-7.849)were influencing factors of the poor prognosis in DFU patients.ROC curve analysis showed that the best threshold of OPNI to predict the prognosis of DFU patients was 44.3,the area under the curve(AUC)was 0.803,the 95%CI was 0.716-0.870,the sensitivity was 0.667,and the specificity was 0.842.Conclusion OPNI is related to the severity of DFU patients and is a risk factor for poor prognosis.It can be used for clinical condition assessment and prognosis judgment of DFU patients.
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