title: Predictive Value of Soluble CD14, Interleukin-6 and Procalcitonin For Lower Extremity Amputation in People with Diabetes with Foot Ulcers: A Pilot Study.
abstract: OBJECTIVE
  The aim of this pilot study was to determine clinical and laboratory factors that predict amputation surgery and to evaluate the predictive value of soluble CD14 (sCD14), interleukin-6 (IL-6), and procalcitonin (PCT) in patients with diabetic foot ulcers (DFUs).
  
  
  METHODS
  Twenty-seven (20 males, 7 females) Diabetic Foot Ulcers (DFU) patients admitted to our department were consecutively enrolled. The patients' demographics and wound characteristics were noted. IL-6, PCT, and sCD14 were measured at admission.
  
  
  RESULTS
  Six of the 27 patients (22%) eventually underwent lower extremity amputation. Compared to the non-amputation group, a previous history of amputation (p=0.017), the presence of gangrene (p=0.044), the Wagner grade (p=0.011), the IL-6 concentration (p=0.018), the white blood cell count (WBC) (p=0.036), and the erythrocyte sedimentation rate (ESR) (p=0.042) were significantly high in the amputation group. However, the sCD14 and PCT concentration were not significantly different.
  
  
  CONCLUSIONS
  We have shown for the first time that IL-6 may have predictive value for lower extremity amputation in patients with DFU. Further studies are needed to confirm its predictive value in this patient group.
authors.affiliation: Ahmet Karakas, Assistant Professor, Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakas
authors.affiliation: Dr. Erol Arslan, Assistant Professor, Department of Medicine, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Arslan
authors.affiliation: Dr. Tolga Cakmak,Department of Aerospace Medicine, Military Hospital, Eskisehir, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Cakmak
authors.affiliation: E.Ozgur Akgul, Associate Professor, Department of Biochemistry, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aydin
authors.affiliation: Seref Demirbas, Assistant Professor, Department of Medicine, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
authors.forename: E Ozgur
authors.initials: EO
authors.lastname: Akgul
authors.affiliation: Senol Yildiz, Professor, Department of Undersea and Hyperbaric Medicinem Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
authors.forename: Seref
authors.initials: S
authors.lastname: Demirbas
keywords: Amputation; Diabetic foot ulcer; Interleukin-6; Procalcitonin; Soluble CD14