In a recent study by Coye et al. (2023), with many of long-time SALSAmigos as coauthors , the effectiveness of C-reactive protein (CRP)/albumin, erythrocyte sedimentation rate (ESR)/albumin ratio, ESR, CRP, and albumin were evaluated to differentiate bone and soft tissue infection in persons with diabetes[1]. The study retrospectively evaluated 242 individuals admitted to the hospital with diabetes-related foot infections (DFI). The DFIs were categorized as either bone (osteomyelitis, OM) or soft tissue infection based on bone culture and/or histology[1].
The median age of the patients was 53 years, with 74% being male. Out of the 224 diabetes-related patients, 125 had been diagnosed with osteomyelitis. The ESR/albumin and CRP/albumin ratios cut-points were >17.84 and >1.83, respectively. The diagnostic parameters for ESR/albumin and CRP/albumin ratios were similar: AUC (0.71,0.71), sensitivity (70.0%, 57.0%), specificity (62.0%, 75.0%), positive predictive value (67.0%, 71.0%), and negative predictive value (66.0% and 71.0%)[1].
In contrast, the diagnostic efficiency of CRP and ESR were AUC 0.71 and 0.71, sensitivity (45.6%, 71.2%), specificity (85.5%, 60.7%), positive predictive value (70.0%, 65.9%), and negative predictive value (59.5%, 66.4%), respectively[1].
The results showed that ESR/albumin was not significantly different from ESR alone (Delong test p vs ESR >0.1). Similarly, CRP/albumin was not significantly different from CRP alone (Delong test p vs CRP>0.1). In conclusion, ESR/albumin and CRP/albumin ratios provided comparable results as using ESR and CRP alone[1].
This study provides valuable insights into the diagnostic accuracy of these biomarkers in differentiating bone and soft tissue infections in persons with diabetes. It suggests that the ratios of ESR/albumin and CRP/albumin can be as effective as using ESR and CRP alone. This could potentially simplify the diagnostic process and provide a more cost-effective approach in managing diabetes-related foot infections[1].
Citations:
[1] https://ppl-ai-file-upload.s3.amazonaws.com/web/direct-files/354343/baa53d3f-7564-4b18-8aa8-b6c7b8dce3a8/Coye et al. 2023 – The infected diabetes-related foot – Comparison of er … erythrocyte sedimentation rate and C-reactive protein to differ[…].pdf
[2] https://ppl-ai-file-upload.s3.amazonaws.com/web/direct-files/354343/5ba477bd-2d95-44c5-b4bd-2f5cf54ab93d/Coye et al. 2023 – The infected diabetes-related foot – Comparison of er … erythrocyte sedimentation rate and C-reactive protein to differ[…].pdf
[3] https://ppl-ai-file-upload.s3.amazonaws.com/web/direct-files/354343/a4376a72-a2b5-4dbc-89c9-9bac4e392c54/Liu et al. 2024 – Modified Tibial Cortex Transverse Transport for Diabetic Foot Ulcers with Wagner Grade ≥ â…¡ – A Study of 98 Patients.pdf
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