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. 2022 Apr 27;11(9):2454.
doi: 10.3390/jcm11092454.

Mortality Risk Associated with Diabetic Foot Complications in People with or without History of Diabetic Foot Hospitalizations

Piergiorgio Francia  1 , Elisa Gualdani  2 , Laura Policardo  2 , Leonardo Bocchi  1 , Flavia Franconi  3 , Paolo Francesconi  2 , Giuseppe Seghieri  2
Affiliations

Mortality Risk Associated with Diabetic Foot Complications in People with or without History of Diabetic Foot Hospitalizations

Piergiorgio Francia et al. J Clin Med. .

Abstract

The aim of this study was to evaluate the risk of death after hospitalizations for diabetic foot (DF) complications, comparing two different cohorts of people with or without a prior history of DF hospitalizations across the years 2011 to 2018 in Tuscany, Italy. The DF complications were categorized by administrative source datasets such as: amputations (both major and minor), gangrene, ulcers, infections, Charcot and revascularizations. A further aim was to present the trend over time of the first ever incidents of diabetic foot hospitalizations in Tuscany. The eight-year-mortality rate was higher in the cohort with prior hospitalizations (n = 6633; 59%) compared with the cohort with first incident DF hospitalizations (n = 5028; 44%). Amputations (especially major ones) and ulcers had the worst effect on survival in people without basal history of DF hospitalizations and respectively in those with a history of prior DF hospitalizations. In both cohorts, revascularization procedures, when compared to ulcers, were associated with a significantly reduced risk of mortality. The prevalence rate of minor amputations showed a slightly rising trend over time. This result agrees with the national trend. Conversely, the progressive increase over time of revascularizations, associated with the fractional decrease in the rate of gangrene, suggests a trend for more proactive behavior by DF care teams in Tuscany.

Keywords: amputations; diabetic foot complications; diabetic foot ulcers; first ever incident diabetic foot hospital admission; hospitalizations; mortality risk.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence rates of hospitalizations for diabetic foot complications across the years 2011 to 2018 in Tuscany (* Logarithmic scale).
Figure 2
Figure 2
Survival probability by Kaplan Meier analysis for diabetic foot complications in people with previous hospitalizations for diabetic foot (A) and after first incident hospitalization for diabetic foot (B).
Figure 3
Figure 3
Adjusted Hazard Ratios (HR) of diabetic foot complications in both cohorts with (▲) and without (◾) previous hospitalizations for diabetic foot. Ulcers are considered here as the reference group.
See this image and copyright information in PMC

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