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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Mader, JK; Haas, W; Aberer, F; Boulgaropoulos, B; Baumann, P; Pandis, M; Horvath, K; Aziz, F; Köhler, G; Pieber, TR; Plank, J; Sourij, H.
Patients with healed diabetic foot ulcer represent a cohort at highest risk for future fatal events.
Sci Rep. 2019; 9(1):10325-10325
Doi: 10.1038/s41598-019-46961-8
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- Leading authors Med Uni Graz
- Mader Julia
- Co-authors Med Uni Graz
- Aberer Felix
- Aziz Faisal
- Baumann Petra Martina
- Boulgaropoulos Beate
- Horvath Karl
- Köhler Gerd
- Pandis Marlene
- Pieber Thomas
- Sourij Harald
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- Abstract:
- Patients with previous diabetic foot ulcer are prone to re-ulceration and (re)amputation, to various comorbidities, have significantly impaired quality of life and increased mortality. We aimed to evaluate the risk of foot related complications and mortality in a high-risk population of patients with healed diabetic foot syndrome over a decade. 91 patients with recently healed diabetic foot ulcer were invited for follow-up at 1, 6 and 11 years after inclusion. Patient characteristics at inclusion were: 40 women, 65 ± 11 years, diabetes type 1 (n = 6) or 2 (n = 85), BMI 28.5 ± 4.4 kg/m2, and HbA1c 68 ± 17 mmol/mol. Comorbidities included neuropathy (n = 91), peripheral artery disease (PAD), history of minor (n = 25) or major (n = 5, 5.5%) amputation, nephropathy (n = 40) and retinopathy (n = 53). Ulceration recurred in 71 (65%) patients, time to first recurrence was 1.8 ± 2.4 years (mean ± SD). 21 patients had to undergo (re)amputation (minor n = 19, major n = 2), time to amputation was 3.6 ± 1.9 years. Over time, 3 further major amputations were required in patients with an initial minor amputation. Thirty-three (36%) of the initially included patients completed the follow-up period of 11.0 ± 0.6 years. 58 patients (64%) died during the observational period, time to death was 5 ± 3 years in this group. We found overall high mortality of 64% throughout the follow-up period of 11 years in high-risk patients with healed diabetic foot syndrome. Presence of PAD, prior amputation and nephropathy as well as poor glycemic control were significantly predictive for death.