Aim: To evaluate surrogate markers commonly used in the literature for osteomyelitis remission after initial treatment for diabetic foot infections (DFIs).
Methods: 35 patients with DFIs were prospectively enrolled and followed for 12 months. Osteomyelitis (OM) was determined from bone culture and histology initially and for recurrence. We used X2 test for dichotomous variables and ANOVA for continuous variables.
Results: 24 patients were diagnosed with OM and 11 with soft-tissue infections (STI). There was no difference between the two groups for OM re-infection, healed ulcers, re-ulceration, re-admission for DFI at the same site, amputation at the same site after discharge. There were more surgeries after discharge in the STI group (p=0.02, Table 1).
Conclusions: OM at the same site based on bone biopsy indicated that 16.7% failed therapy; this was the only direct measure of OM. Indirect markers demonstrated a higher rate of failure. Failure ranged from 8.3-20.8% with surrogate markers. Most OM markers were similar to markers in STI subjects. Surrogate markers should not be the sole criteria used in place of more accurate measures such as advanced imaging or the gold standard of a bone culture and histopathology.
P.A. Crisologo: None. J. La Fontaine: None. K. Davis: None. D. Wukich: Consultant; Self; Orthofix. Other Relationship; Self; Arthrex. L.A. Lavery: Consultant; Self; Bayer US, Boehringer Ingelheim Pharmaceuticals, Inc., Medline Industries, Inc. Research Support; Self; Cardinal Health, EO2 Concepts, Integra LifeSciences, MedImmune, Osiris Therapeutics, Inc.
National Institute of Diabetes and Digestive and Kidney Diseases (3U24DK076169-08S4)