Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers
This study aims to evaluate clinical and ulcer characteristics as well the outcomes of patients with diabetic foot ulcers (DFUs). The study group was composed of DFUs patients managed by a limb salvage protocol according to guidance. Clinical and ulcers findings were described, and 1-year outcomes d...
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MDPI AG
2020-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/6/1780 |
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| author | Marco Meloni Valentina Izzo Laura Giurato José Luis Lázaro-Martínez Luigi Uccioli |
| author_facet | Marco Meloni Valentina Izzo Laura Giurato José Luis Lázaro-Martínez Luigi Uccioli |
| author_sort | Marco Meloni |
| collection | DOAJ |
| description | This study aims to evaluate clinical and ulcer characteristics as well the outcomes of patients with diabetic foot ulcers (DFUs). The study group was composed of DFUs patients managed by a limb salvage protocol according to guidance. Clinical and ulcers findings were described, and 1-year outcomes defined as limb salvage, healing, healing time, major amputation and death were compared between neuropathic and ischemic DFUs. One thousand, one hundred and ninety-eight subjects were included; 386 (32.2%) neuropathic and 812 (67.8%) ischemic DFUs. Neuropathic patients were younger (69.5 ± 11.5 vs. 74.5 ± 11.5, <i>p</i> < 0.0001) and reported less cases of nephropathy (22.8 vs. 39.6%, <i>p</i> < 0.0001), ischemic heart disease (22.8 vs. 36.9, <i>p</i> = 0.0004), cerebrovascular disease (8.3 vs. 17.2%, <i>p</i> = 0.002), heart failure (10.1 vs. 24.7%, <i>p</i> = 0.0002) and end-stage-renal-disease (ESRD) (5.4 vs. 27%, <i>p</i> = 0.0001) than ischemic patients; they also showed less cases of large (>5 cm<sup>2</sup>) (10.3 vs. 22.9%, <i>p</i> = 0.0007), infected (40.4 vs. 55.7%, <i>p</i> = 0.0005) and deep to the bone (22.3 vs. 39.2, <i>p</i> = 0.0002) ulcers, as well less multiple ulcerations (21.8 vs. 32.8%, <i>p</i> = 0.006) than patients with ischemic DFUs. The outcomes for neuropathic and ischemic DFUs were limb salvage (98.4 vs. 82.3%, <i>p</i> < 0.0001), healing (97.3 vs. 79.6%, <i>p</i> < 0.0001), healing time (34.9 vs. 35.6 weeks, <i>p</i> = 0.8), major amputation (0.5 vs. 6.6%, <i>p</i> = 0.0001), death (1.1 vs. 11%, <i>p</i> < 0.0001) respectively. Revascularization failure and ESRD were independent predictors of major amputation, while heart failure and number of co-morbidities (≥5) were independent predictors of death. Ischemic DFUs patients showed more severe clinical and ulcers features as well worse outcomes than neuropathic DFUs patients. |
| first_indexed | 2024-03-10T19:19:20Z |
| format | Article |
| id | doaj.art-d5f86ea2dd4e4eafa85fdf9f6f84fb12 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:19:20Z |
| publishDate | 2020-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-d5f86ea2dd4e4eafa85fdf9f6f84fb122023-11-20T03:10:46ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0196178010.3390/jcm9061780Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic UlcersMarco Meloni0Valentina Izzo1Laura Giurato2José Luis Lázaro-Martínez3Luigi Uccioli4Diabetic Foot Unit, Department of Medicina dei Sistemi, University of Tor Vergata, 00133 Rome, ItalyDiabetic Foot Unit, Department of Medicina dei Sistemi, University of Tor Vergata, 00133 Rome, ItalyDiabetic Foot Unit, Department of Medicina dei Sistemi, University of Tor Vergata, 00133 Rome, ItalyDiabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria de Hospital Clinico San Carlos (IdISSC), 28040 Madrid, SpainDiabetic Foot Unit, Department of Medicina dei Sistemi, University of Tor Vergata, 00133 Rome, ItalyThis study aims to evaluate clinical and ulcer characteristics as well the outcomes of patients with diabetic foot ulcers (DFUs). The study group was composed of DFUs patients managed by a limb salvage protocol according to guidance. Clinical and ulcers findings were described, and 1-year outcomes defined as limb salvage, healing, healing time, major amputation and death were compared between neuropathic and ischemic DFUs. One thousand, one hundred and ninety-eight subjects were included; 386 (32.2%) neuropathic and 812 (67.8%) ischemic DFUs. Neuropathic patients were younger (69.5 ± 11.5 vs. 74.5 ± 11.5, <i>p</i> < 0.0001) and reported less cases of nephropathy (22.8 vs. 39.6%, <i>p</i> < 0.0001), ischemic heart disease (22.8 vs. 36.9, <i>p</i> = 0.0004), cerebrovascular disease (8.3 vs. 17.2%, <i>p</i> = 0.002), heart failure (10.1 vs. 24.7%, <i>p</i> = 0.0002) and end-stage-renal-disease (ESRD) (5.4 vs. 27%, <i>p</i> = 0.0001) than ischemic patients; they also showed less cases of large (>5 cm<sup>2</sup>) (10.3 vs. 22.9%, <i>p</i> = 0.0007), infected (40.4 vs. 55.7%, <i>p</i> = 0.0005) and deep to the bone (22.3 vs. 39.2, <i>p</i> = 0.0002) ulcers, as well less multiple ulcerations (21.8 vs. 32.8%, <i>p</i> = 0.006) than patients with ischemic DFUs. The outcomes for neuropathic and ischemic DFUs were limb salvage (98.4 vs. 82.3%, <i>p</i> < 0.0001), healing (97.3 vs. 79.6%, <i>p</i> < 0.0001), healing time (34.9 vs. 35.6 weeks, <i>p</i> = 0.8), major amputation (0.5 vs. 6.6%, <i>p</i> = 0.0001), death (1.1 vs. 11%, <i>p</i> < 0.0001) respectively. Revascularization failure and ESRD were independent predictors of major amputation, while heart failure and number of co-morbidities (≥5) were independent predictors of death. Ischemic DFUs patients showed more severe clinical and ulcers features as well worse outcomes than neuropathic DFUs patients.https://www.mdpi.com/2077-0383/9/6/1780diabetesdiabetic foot ulcersco-morbiditieswound healingamputation |
| spellingShingle | Marco Meloni Valentina Izzo Laura Giurato José Luis Lázaro-Martínez Luigi Uccioli Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers Journal of Clinical Medicine diabetes diabetic foot ulcers co-morbidities wound healing amputation |
| title | Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers |
| title_full | Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers |
| title_fullStr | Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers |
| title_full_unstemmed | Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers |
| title_short | Prevalence, Clinical Aspects and Outcomes in a Large Cohort of Persons with Diabetic Foot Disease: Comparison between Neuropathic and Ischemic Ulcers |
| title_sort | prevalence clinical aspects and outcomes in a large cohort of persons with diabetic foot disease comparison between neuropathic and ischemic ulcers |
| topic | diabetes diabetic foot ulcers co-morbidities wound healing amputation |
| url | https://www.mdpi.com/2077-0383/9/6/1780 |
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