Prognostic Utility of SINBAD and DUSS Scoring Systems in Predicting Outcomes of Diabetic Foot Ulcers: A Prospective Cohort Study
DOI:
https://doi.org/10.52783/jns.v14.2335Keywords:
Diabetic Foot Ulcers, Amputation, SINBAD Score, DUSS Score, Diabetic Neuropathy, Peripheral Arterial Disease, Prognostic Classification, Wound Healing, Predictive ModellingAbstract
Background and Objectives: Diabetic foot ulcers (DFUs) are one of the most serious complications of diabetes mellitus, leading to significant morbidity and risk of lower extremity amputations (LEAs). The SINBAD classification system and Diabetic Ulcer Severity Score (DUSS) have been proposed as predictive tools for ulcer outcomes, but no gold standard exists for prognostication. This study aims to evaluate the role of SINBAD and DUSS scores in predicting DFU outcomes, particularly healing and amputation rates.
Methods: A prospective cohort study was conducted at Tirunelveli Medical College from October 2022 to December 2023, involving 224 diabetic foot ulcer patients. Patients were assessed using SINBAD and DUSS scoring systems, and outcomes were monitored over six months. The primary outcome measures were ulcer healing and amputation. Statistical analyses included chi-square tests, independent t-tests, ROC curve analysis, and diagnostic accuracy tests to assess the predictive validity of SINBAD and DUSS scores.
Results: Among 224 patients, amputation was performed in 80 (35.7%) cases. The mean age of amputated patients was 59.99±11.12 years, compared to 57.10±11.55 years in non-amputated patients (p=0.07). Gender distribution showed a significant association, with males comprising 71% of the sample but having a lower amputation rate (p=0.007). The presence of infection, gangrene, and ascending cellulitis significantly correlated with amputation rates. ROC curve analysis indicated that SINBAD and DUSS scores had good predictive validity for amputation, with optimal cut-off values demonstrating high sensitivity and specificity.
Conclusion: The SINBAD and DUSS scoring systems are effective tools for predicting diabetic foot ulcer outcomes. A SINBAD score ≥3 was associated with a higher likelihood of delayed healing and amputation. Implementing these classification systems in routine clinical practice can aid in risk stratification and targeted management of DFUs.
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