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Meta-Analysis
. 2019 Dec;16(6):1373-1382.
doi: 10.1111/iwj.13200. Epub 2019 Sep 6.

Risk factors for the recurrence of diabetic foot ulcers among diabetic patients: a meta-analysis

Ze-Hao Huang  1 , Si-Qing Li  1 , Yan Kou  1 , Lei Huang  2 , Ting Yu  2 , Ailing Hu  2
Affiliations
Meta-Analysis

Risk factors for the recurrence of diabetic foot ulcers among diabetic patients: a meta-analysis

Ze-Hao Huang et al. Int Wound J. 2019 Dec.

Erratum in

  • Corrigenda.
    [No authors listed] [No authors listed] Int Wound J. 2020 Apr;17(2):523. doi: 10.1111/iwj.13327. Int Wound J. 2020. PMID: 32115897 Free PMC article. No abstract available.

Abstract

This study aimed to systematically review and identify the risk factors for the recurrence of diabetic foot ulcers (DFUs) among diabetic patients. PUBMED, EMBASE, Web of Science, Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases were electronically searched to identify eligible studies updated to January 2019 to collect case-control studies or cohort studies on the risk factors for the recurrence of DFUs. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies using the Newcastle-Ottawa Scale. A meta-analysis was performed using RevMan 5.3. Nine retrospective cohort studies were included, in which 1426 patients were enrolled, 542 in the DFU recurrence group and 884 in the non-recurrent DFU group. Risk factors for the recurrence of DFUs included male gender (odds ratio [OR] = 1.38, 95% confidence interval [CI], 1.07-1.78, P < .05), smoking (OR = 1.66, 95% CI, 1.26-2.20, P = .0004), duration of diabetes (WMD = 4.43, 95% CI, 1.96‐6.90, P = .0004), duration of past DFUs (OR = 1.02, 95% CI, 1.00-1.03, P = .006), plantar ulcers (OR = 5.31, 95% CI, 4.93-5.72, P <.00001), peripheral artery disease (OR = 1.65, 95% CI, 1.20-2.28, P = .002), and diabetic peripheral neuropathy (OR = 2.15, 95% CI, 1.40-3.30, P = .0005). No significant differences were found in age, body mass index, total cholesterol, diabetic nephropathy, diabetic retinopathy, or hypertension. Health care staff should pay attention to the identified risk factors for the recurrence of DFUs. Because of the limited quality and quantity of the included studies, rigorous studies with adequate sample sizes are needed to verify the conclusion.

Keywords: diabetic foot ulcer; meta-analysis; recurrence; risk factor.

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Figures

Figure 1
Figure 1
Flow diagram of the literature search
Figure 2
Figure 2
Forest plot: effect of age on diabetic foot ulcer recurrence
Figure 3
Figure 3
Forest plot: effect of gender on diabetic foot ulcer recurrence
Figure 4
Figure 4
Forest plot: effect of smoking on diabetic foot ulcer recurrence
Figure 5
Figure 5
Forest plot: effect of body mass index on diabetic foot ulcer recurrence
Figure 6
Figure 6
Forest plot: effect of the duration of diabetes on diabetic foot ulcer recurrence
Figure 7
Figure 7
Forest plot: effect of the long duration of past diabetic foot ulcers (DFUs) on DFU recurrence
Figure 8
Figure 8
Forest plot: effect of the plantar ulcers on diabetic foot ulcer recurrence
Figure 9
Figure 9
Forest plot: effect of peripheral artery disease on diabetic foot ulcer recurrence
Figure 10
Figure 10
Forest plot: effect of diabetic peripheral neuropathy on diabetic foot ulcer recurrence
Figure 11
Figure 11
Forest plot: effect of diabetic nephropathy on diabetic foot ulcer recurrence
Figure 12
Figure 12
Forest plot: effect of diabetic retinopathy on diabetic foot ulcer recurrence
Figure 13
Figure 13
Forest plot: effect of hypertension on diabetic foot ulcer recurrence
Figure 14
Figure 14
Forest plot: effect of TC on diabetic foot ulcer recurrence
See this image and copyright information in PMC

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