Seguimiento a largo plazo de marcadores analíticos y radiológicos de los pacientes diabéticos con sospecha clínica de osteomielitis tras el cierre completo de su lesión

Abstract

¿ Introduction: Currently, there is a need to identify and formulate clear criteria for the cure of diabetic foot osteomyelitis. This will permit in turn to establish evolution and resolution indicators based on analytical and radiological markers. Aim: To identify the predictive capacity of different analytical and radiological parameters in the onset of a complication event. Methods: We conducted a prospective observational study with 116 patients diagnosed with diabetic foot osteomyelitis. Blood tests and radiographs were analysed after ulcer healing in a follow-up of 12 months. Results: Regarding parameters affecting a complication event, we observed that elevated values of lymphocytes and albumin are predictive factors at 12-month follow-up once the ulcer has healed. The elevation of erythrocyte sedimentation rate and the absence of cure according to radiology had predictive and diagnostic value in the onset of a complication event. In contrast, the elevation of C-reactive protein and blood glucose were diagnostic factors since their elevation occurs during the onset of the event. Discussion: It is necessary to include long-term follow-up models in patients with diabetic foot osteomyelitis after ulcer healing, using blood tests and serial radiographs. Current recommendations in patients in remission period of osteomyelitis could cause a delay in the detection of complications that may arise during long-term. Conclusions: In the remission period of the patients with diabetic foot osteomyelitis, the analytical parameters associated with the onset of complications during the follow-up are: elevation of lymphocyte values, erythrocyte sedimentation rate, C-reactive protein, albumin and blood glucose. Absence of cure according to radiology is a risk factor for the development of complications during the period of remission of diabetic foot osteomyelitis.