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Jan Apelqvist

Physician

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Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study

Author

  • L. Prompers
  • N. Schaper
  • Jan Apelqvist
  • M. Edmonds
  • E. Jude
  • D. Mauricio
  • L. Uccioli
  • V. Urbancic
  • K. Bakker
  • P. Holstein
  • A. Jirkovska
  • A. Piaggesi
  • G Ragnarson-Tennvall
  • H. Reike
  • M. Spraul
  • K. Van Acker
  • J. Van Baal
  • F. Van Merode
  • I. Ferreira
  • M. Huijberts

Summary, in English

Aims/hypothesis Outcome data on individuals with diabetic foot ulcers are scarce, especially in those with peripheral arterial disease (PAD). We therefore examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients and examined whether such predictors differ between patients with and without PAD. Methods Analyses were conducted within the EURODIALE Study, a prospective cohort study of 1,088 diabetic foot ulcer patients across 14 centres in Europe. Multiple logistic regression modelling was used to identify independent predictors of outcome (i.e. non-healing of the foot ulcer). Results After 1 year of follow-up, 23% of the patients had not healed. Independent baseline predictors of non-healing in the whole study population were older age, male sex, heart failure, the inability to stand or walk without help, end-stage renal disease, larger ulcer size, peripheral neuropathy and PAD. When analyses were performed according to PAD status, infection emerged as a specific predictor of non-healing in PAD patients only. Conclusions/Interpretation Predictors of healing differ between patients with and without PAD, suggesting that diabetic foot ulcers with or without concomitant PAD should be defined as two separate disease states. The observed negative impact of infection on healing that was confined to patients with PAD needs further investigation.

Department/s

  • Genomics, Diabetes and Endocrinology

Publishing year

2008

Language

English

Pages

747-755

Publication/Series

Diabetologia

Volume

51

Issue

5

Document type

Journal article

Publisher

Springer

Topic

  • Endocrinology and Diabetes

Keywords

  • predictive model
  • peripheral arterial disease
  • outcome
  • non-healing
  • infection
  • foot ulcer
  • co-morbidities
  • diabetes

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1432-0428