Aim The diabetic foot attack (DFA) is perhaps the most devastating form of diabetic foot infection, presenting with rapidly progressive skin and tissue necrosis, threatening both limb and life. However, clinical outcome data in this specific group of patients are not available. Methods Analysis of 106 consecutive patients who underwent emergency hospitalisation for DFA (TEXAS Grade 3B or 3D and Infectious Diseases Society of America (IDSA) Class 4 criteria). Outcomes evaluated were: 1) Healing 2) major amputation 3) death 4) not healed. The first outcome reached in one of these four categories over the follow-up period (18.4±3.6 months) was considered. We also estimated amputation free survival. Results Overall, 57.5% (n=61) healed, 5.6% (n=6) underwent major amputation, 23.5% (n=25) died without healing and 13.2% (n=14) were alive without healing. Predictive factors associated with outcomes were: Healing (age<60, p=0.0017; no Peripheral arterial disease (PAD) p= 0.002; not on dialysis p=0.006); major amputation (CRP>100 mg/L, p=0.001; gram+ve organisms, p=0.0013; dialysis, p= 0.001), and for death (age>60, p= 0.0001; gram+ve organisms p=0.004; presence of PAD, p=0.0032; CRP, p=0.034). The major amputation free survival was 71% during the first 12 months from admission, however it had reduced to 55.4% by the end of the follow-up period. Conclusions In a unique population of hospitalised individuals with DFA, we report excellent healing and limb salvage rates using a dedicated protocol in a multidisciplinary setting. An additional novel finding was the concerning observation that such an admission was associated with high 18-month mortality, almost all of which was after discharge from hospital.

中文翻译：

---

糖尿病足发作紧急入院后的结果表明治愈率和保肢率高，但死亡率增加：18 个月的随访研究

目的 糖尿病足发作 (DFA) 可能是糖尿病足感染中最具破坏性的形式，表现为快速进展的皮肤和组织坏死，威胁肢体和生命。然而，尚无该特定患者组的临床结果数据。方法对 106 例因 DFA（TEXAS 3B 或 3D 级和美国传染病学会 (IDSA) 4 级标准）接受紧急住院治疗的连续患者进行分析。评估的结果是：1) 愈合 2) 大截肢 3) 死亡 4) 未愈合。考虑了在随访期间（18.4±3.6 个月）在这四个类别之一中达到的第一个结果。我们还估计了无截肢存活率。结果 总体而言，57.5%（n=61）治愈，5.6%（n=6）进行大截肢，23.5%（n=25）未治愈死亡，13.2%（n=14）未治愈存活。与结果相关的预测因素是：愈合（年龄<60，p=0.0017；无外周动脉疾病 (PAD) p=0.002；未进行透析 p=0.006）；大截肢（CRP>100 mg/L，p=0.001；gram+ve 微生物，p=0.0013；透析，p=0.001）和死亡（年龄>60，p=0.0001；gram+ve 微生物 p=0.004； PAD 的存在，p=0.0032；CRP，p=0.034）。入院后前 12 个月的主要无截肢生存率为 71%，但到随访期结束时已降至 55.4%。结论 在一个独特的 DFA 住院患者群体中，我们报告了在多学科环境中使用专用协议的良好愈合率和保肢率。另一个新发现是令人担忧的观察结果，即此类入院与 18 个月的高死亡率相关，