{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:08:44Z","timestamp":1780448924454,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this paper was to investigate erythrocyte sedimentation rate (ESR) and c\u2010reactive protein (CRP) in diagnosing pedal osteomyelitis (OM) in patients with and without diabetes, and with and without severe renal impairment (SRI). This was a retrospective cohort study of patients with moderate and severe foot infections. We evaluated three groups: Subjects without diabetes (NDM), subjects with diabetes and without severe renal insufficiency (DM\u2010NSRI), and patients with diabetes and SRI (DM\u2010SRI). SRI was defined as eGFR &lt;30. We evaluated area under the curve (AUC), cutoff point, sensitivity and specificity to characterize the accuracy of ESR and CRP to diagnose OM. A total of 408 patients were included in the analysis. ROC analysis in the NDM group revealed the AUC for ESR was 0.62, with a cutoff value of 46\u2009mm\/h (sensitivity, 49.0%; specificity, 76.0%). DM\u2010NSRI subjects showed the AUC for ESR was 0.70 with the cutoff value of 61\u2009mm\/h (sensitivity, 68.9%; specificity 61.8%). In DM\u2010SRI, the AUC for ESR was 0.67, with a cutoff value of 119\u2009mm\/h (sensitivity, 46.4%; specificity, 82.40%). In the NDM group, the AUC for CRP was 0.55, with a cutoff value of 6.4\u2009mg\/dL (sensitivity, 31.3%; specificity, 84.0%). For DM\u2010NSRI, the AUC for CRP was 0.70, with a cutoff value of 8\u2009mg\/dL (sensitivity, 49.2%; specificity, 80.6%). In DM\u2010SRI, the AUC for CRP was 0.62, with a cutoff value of 7\u2009mg\/dL (sensitivity, 57.1%; specificity, 67.7%). While CRP demonstrated relatively consistent utility, ESR's diagnostic cutoff points diverged significantly. These results highlight the necessity of considering patient\u2010specific factors when interpreting ESR results in the context of OM diagnosis.<\/jats:p>","DOI":"10.1111\/iwj.14770","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T19:40:16Z","timestamp":1710445216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The infected diabetic foot: Modulation of traditional biomarkers for osteomyelitis diagnosis in the setting of diabetic foot infection and renal impairment"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8598-8350","authenticated-orcid":false,"given":"Tyler L.","family":"Coye","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Andrew","family":"Crisologo","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-0909","authenticated-orcid":false,"given":"Mehmet A.","family":"Suludere","sequence":"additional","affiliation":[{"name":"Department of Immunology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Malone","sequence":"additional","affiliation":[{"name":"Limb Preservation and Wound Research Academic Unit, Liverpool Hospital, South Western Sydney LHD  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan K.","family":"Oz","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence A.","family":"Lavery","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","article-title":"Effect of sensory neuropathy on the predictive value of inflammatory biomarkers for osteomyelitis in diabetic and nondiabetic patients with foot infections","volume":"112","author":"Ryan E","year":"2022","journal-title":"J Am Podiatr Med Assoc"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14830"},{"issue":"2","key":"e_1_2_8_4_1","first-page":"461","article-title":"Is ischaemic modified albumin a marker in osteomyelitis patients?","volume":"71","author":"Adanas C","year":"2021","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265769"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12146"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-010-0128-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2251"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3280"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118548387"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.06.027"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.11.030"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2013.765589"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/380449"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.9.2129"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/385641"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.836"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470090080036"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2007.03.004"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.08.009"},{"issue":"6","key":"e_1_2_8_22_1","first-page":"CR307","article-title":"The diagnosis of diabetic foot osteomyelitis: Examination findings and laboratory values","volume":"15","author":"Ertugrul BM","year":"2009","journal-title":"Med Sci Monit"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2008.09.003"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.05.023"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734613486152"},{"issue":"1","key":"e_1_2_8_26_1","first-page":"37","article-title":"Pro\u2010calcitonin, erythrocyte sedimentation rate and C\u2010reactive protein in predicting diabetic foot ulcer characteristics; 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