Diabetes Foot Ulceration

Published Date: 19th July 2016

Publication Authors: Hart-Pinto AD, Beeharry D, Hardy KJ,

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Aims:  The presence of foot ulceration is associated with increased morbidity and mortality. This study aimed to determine the factors associated with mortality among patients with foot ulcers attending a multidisciplinary diabetes foot clinic.

Methods:  All patients reviewed consecutively in a multidisciplinary diabetes foot clinic with new foot ulceration between 1 January 2010 and 30 June 2011 were included in this retrospective, observational study. Data about mortality was obtained until June 2012. Patients with Charcot neuroarthropathy were excluded. Data were collected from hospital electronic case notes (EDMS), pathology and radiology PACS systems.

Results:  The cohort included 158 (62% men) patients. Twenty four of the 158 patients (15.2%) died since first review in the multidisciplinary diabetes foot clinic. Mortality was associated with older age [mean (SD), 75 (15.9) vs 65 (13.2) years, p = 0.003], lower HbA1c [7.0 (1.45) vs 7.8 (2.0), p = 0.02] and lower estimated glomerular filtration rate [51.1 (17) vs 70.2 (19.3), p <0.001] compared with the rest of the cohort. Mortality was also associated with higher prevalence of ischaemic heart disease, peripheral arterial disease and cerebrovascular disease but not hypertension, hyperlipidaemia, neuropathy and retinopathy.

Conclusions:  Further research is needed to determine whether greater attention to cardiovascular risk factors among patient with foot ulceration reduces mortality.

Hart-Pinto, AD; Beeharry, D; Hardy, KJ; Srinivas-Shankar, U. (2013).  Factors associated with mortality among patients with diabetes foot ulceration . Diabetic Medicine. 30 (Supplement S1), 142-3

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