Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type

Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective s...

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Bibliographic Details
Published in:Journal of diabetes research 2016-01, Vol.2016 (2016), p.1-7
Main Authors: Chammas, N. K., Edmonds, M. E., Hill, R. L. R.
Format: Article
Language:English
Subjects:
Age
Age Factors
Aged
Aged, 80 and over
Aneurysms
Atherosclerosis
Cardiovascular disease
Cause of Death
Certification
Chronic obstructive pulmonary disease
Coronary vessels
Diabetes
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Diabetic Foot - epidemiology
Diabetic Foot - etiology
Diabetic Neuropathies - epidemiology
Diabetic Neuropathies - etiology
Female
Foot diseases
Health risk assessment
Heart attacks
Humans
Ischemia - epidemiology
Ischemia - etiology
Leg ulcers
Male
Middle Aged
Mortality
Myocardial Ischemia - mortality
Retrospective Studies
Thromboembolism
Thrombosis
United Kingdom - epidemiology
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Summary:Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective study on DFU patients who attended King’s College Hospital Foot Clinic and subsequently died. A control group of nonulcerated diabetic patients was matched for age and type of diabetes mellitus. The cause of death was identified from death certificates (DC) and postmortem (PM) examinations. There were 243 DFU patient deaths during this period. Ischaemic heart disease (IHD) was the major cause of death in 62.5% on PM compared to 45.7% on DC. Mean age at death from IHD on PM was 5 years lower in DFU patients compared to controls (68.2 ± 8.7 years versus 73.1 ± 8.0 years, P = 0.015 ). IHD as a cause of death at PM was significantly linked to neuropathic foot ulcers (OR 3.064, 95% CI 1.003–9.366, and P = 0.049 ). Conclusions. IHD is the major cause of premature mortality in DFU patients with the neuropathic foot ulcer patients being at a greater risk.
ISSN:2314-6745
2314-6753
DOI:10.1155/2016/2879809