Predicting the risk of amputation and death in patients with diabetic foot ulcer. A long‐term prospective cohort study of patients in Tanzania

• Published in: Endocrinology, diabetes & metabolism diabetes & metabolism, 2022-05, Vol.5 (3), p.e00336-n/a
• Main Authors: Abbas, Zulfiqarali G., Chockalingam, Nachiappan, Lutale, Janet K., Naemi, Roozbeh
• Format: Article
• Language: English
• Subjects: Africa; Age; Amputation; Amputation - adverse effects; Blood; Body mass index; Cohort analysis; Diabetes; Diabetes Mellitus; Diabetic Foot - etiology; Diabetic Foot - surgery; Foot diseases; foot ulcer; Gangrene; Humans; Hypertension; Kidney diseases; Leg ulcers; Mortality; Patients; peripheral arterial disease; Peripheral Arterial Disease - complications; peripheral neuropathy; Prospective Studies; Risk Factors; Smoking; Systematic review; Tanzania - epidemiology; Ulcer - complications
• ISSN: 2398-9238; 2398-9238
• DOI: 10.1002/edm2.336

Introduction This prospective cohort study aimed to identify the characteristics of patients with diabetic foot ulcer who are at higher risk of amputation and at increased risk of death. Methods About 103(M/F:60/43) participants, with active foot ulcer at baseline, participated in this study and followed for 22 years till death or lost to follow‐up. Ten clinical measures were collected at baseline. During the follow‐up of 4.2 ± 5.4 years, 22(M/F:14/8) participants had an amputation and 50(M/F:32/18) participants passed away during 5.5 ± 5.8 years follow‐up period. Results Cox Proportional Hazard regression (HR[95%CI]) indicated neuropathy (6.415[1.119–36.778]); peripheral arterial disease (PAD) (9.741[1.932– 49.109]); current smoking (16.148[1.658–157.308]); diabetes type‐ 1 (3.228[1.151–9.048]) and longer delay attending appointment after ulcer (1.013[1.003–1.023]) were significantly (p