Patients with diabetic foot ulcers (DFU) have a high mortality risk, researchers found in a recent study.
Between January 2003 and June 2015, first-time DFU patients at the Multi-Disciplinary Foot Clinic at Royal Darwin Hospital, Northern Territory Australia were followed until 2017 or death. Hospital and primary care information systems were used to find individual patient data. Kaplan-Meier survival curves were used, and Cox regression was used to evaluate the association between certain risk factors and mortality.
#DidYouKnow Diabetic foot ulcers are common – in fact, One in Four people with diabetes will develop at least one ulcer post-diagnosis.
— Vascular & Cardiothoracic Associates of Maryland (@vctamd) January 8, 2019
Of 666 patients who were screened, 513 were included in the study (median follow-up, 5.8 years; mean age at baseline, 59.9 years; 62.8% male). Nearly all (93.6%) patients had type 2 diabetes; median disease duration was seven years. One hundred ninety-nine patients died; nearly a quarter (24.6%) died within five years, and 45.4% died within a decade (mean age at death, 64.6 years). A multivariate analysis found that certain factors were also associated with mortality (adjusted HR, 95% CI), including age (1.04, 1.02–1.05, P < 0.001), chronic kidney disease (1.22, 1.11–1.33, P < 0.001), and plasma albumin (0.96, 0.94–0.99, P < 0.05). Patients were most likely to die due to chronic kidney disease (24.6%), cardiovascular events (19.6%), sepsis (15.6%), respiratory failure (10.0%), malignancy (9.5%) and multi-organ failure (5.0%).
15% of patients with diabetes develop #footulcers. If you notice an ulcer on your foot, seek care immediately to improve function and quality of life and reduce the risk of #infection and possible amputation. pic.twitter.com/nGh7QACH16
— Goldsmith Podiatry (@GoldsmithFootDr) January 7, 2019
One of the study’s limitations was its retrospective nature, allowing for potential ascertainment bias. There were also no patients with simple superficial ulcers included in the study, as those are treated in a primary care setting, meaning the study’s findings may not apply to this population.
The researchers concluded, “The presence of a DFU should be seen by health care providers as an alarming signal to premature death, and should be used to initiate intensive risk factor reduction and close follow-up.”
Source: BMC Endocrine Disorders