Comparison of Three Scoring Systems in Prediction of Limb Outcome among Patients with Diabetic Foot Ulcers

Abstract Introduction: The prevalence of diabetes and diabetic foot ulcers are rising world-wide. Diabetics are prone for wound infection and vulnerable for limb complications like amputation (major or minor) subsequently. Various grading or scoring systems have evolved over a period of time (e.g., Wagner’s Grading, University of Texas grading and PEDIS classification) to assess the severity of infection and disease among the diabetics and can predict the limb outcomes (ulcer healing/ minor or major amputations) as well. But the predictive abilities of these commonly used scoring systems are not consistent and varies in different studies. Patients and Methods: This was a cross-sectional, observational study conducted over one hundred patients and had compared the ability of various scoring systems (University of Texas, Wagner’s and PEDIS) in prediction of limb outcome (Ulcer healed/ minor amputation/ major amputation) among patients with diabetic foot ulcers. Results: It was observed that with increase in ulcer grades/ scores, chances of amputations were higher in all three scoring systems ( P value < .0001). However, the increase in amputation rates were steadier and predicted earlier in PEDIS classification system as compared to other two grading systems. Conclusion: In our study, all three classification systems were found to be a good predictor of limb outcome. However, PEDIS was found better in detecting poor outcome earlier than other two classification systems.