International Surgery Journal | June 2020 | Vol 7 | Issue 6 Page 1830 International Surgery Journal Karnawat AV et al. Int Surg J. 2020 Jun;7(6):1830-1835 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Systemic inflammatory response syndrome as a predictor of poorer outcomes in diabetic foot infection: a prospective analytical study Anand Vinay Karnawat 1 , Vijayakumar Chellappa 1 , Balasubramanian Gopal 1 *, Rajkumar Nagarajan 1 , Krishnamachari Srinivasan 2 INTRODUCTION Diabetes mellitus has been a global epidemic of 21 st century. In 2015, International Diabetes Federation (IDF) published its seventh atlas, which estimated that 415 million people among the adults of age group 20-79 years worldwide are suffering from diabetes mellitus. Which amounts to 8.8% of adults aged between 20-79 years of age. One in eleven adults is suffering from diabetes mellitus. Taking ongoing trends into consideration IDF predicted by 2040, 642 million people worldwide will be diabetic. India is house for 69.2 million diabetics. It ranks second in the absolute number of diabetics following China at first place. 1 Most dreaded complication of diabetes mellitus is lower extremity amputations. Patients who are undergoing lower extremity amputation will require ipsilateral or contralateral amputation within next three to five years. Five-year mortality related to diabetic foot ulcer is very high. According to Moulik et al, five-year mortality rate for patients with diabetic foot ulcer is 45%, 18% and 55% ABSTRACT Background: This study was done to diagnose the severity of infection in a group of hospitalized diabetic foot infection (DFI) patients based on the presence or absence of systemic inflammatory response syndrome (SIRS) and compare the outcomes. Methods: This was a single-center cohort study, in which 50 consecutive DFI patients having SIRS and 50 consecutive patients not having SIRS were included. Patients were followed for the duration of the hospital stay; parameters for glycaemic control, minor and major amputation, microbial culture, duration of hospital and ICU stay and mortality was recorded. Results: The relative risk of major amputation among the patients of DFI who presented with SIRS was 2.66 times higher compared to who was not having SIRS at presentation (95% CI, 1.56-4.55). The presence of polymicrobial infection also had a statistically significant association with the incidence of major amputation. The duration of hospital stay was ~9.5 days longer in the DFI patients who presented with SIRS compared to who was not having SIRS at the time of presentation [8.00 (4.00-20.50) days versus 17.50 (10.75-38.25) days]. DFI patients with SIRS required a significantly prolonged ICU. Conclusions: SIRS can be used as objective criteria to predict poorer outcomes in the diabetic foot infection patient and also to classify it. Keywords: DFI, Morbitity, Sepsis, SIRS, Quality of life 1 Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India 2 Department of Surgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry India Received: 01 March 2020 Revised: 10 April 2020 Accepted: 30 April 2020 *Correspondence: Dr. Balasubramanian Gopal, E-mail: drbala18@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20202391