한국간호과학회

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  • JKAN(Journal of Korean Academy of Nursing)

JKAN(Journal of Korean Academy of Nursing)

년도별 ‘권’과 ‘호’를 선택해 주세요 (ISSN 1598-2874(38권 4호까지), ISSN 2005-3673(38권 5호부터)

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제목 Development of a Diabetic Foot Ulceration Prediction Model and Nomogram
저자 : Lee, Eun Joo · Jeong, Ihn Sook · Woo, Seung Hun · Jung, Hyuk Jae · Han, Eun Jin · Kang, Chang Wan · Hyun, Sookyung 게시일 : 2021년 06월 페이지 : p280~p293
저자 Lee, Eun Joo · Jeong, Ihn Sook · Woo, Seung Hun · Jung, Hyuk Jae · Han, Eun Jin · Kang, Chang Wan · Hyun, Sookyung 게시일 2021년 06월 페이지 p280~p293 인쇄
파일 (03) JKAN20-257(+s).pdf (03) JKAN20-257_Supple.pdf
키워드 Diabetic Foot; Foot Ulcer; Logistic Models; Risk
Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients’ electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow–Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ 2 = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.