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Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study

This study aimed to explore the risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis (DFO) and diabetic nephropathy (DN). This is a prospective cohort study. Between May 2018 and May 2021, we selected 120 inpatients with comorbid severe diabetic foot infection...

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Autores principales: Zhang, Li, Fu, Guifen, Deng, Yongqing, Nong, Yuechou, Huang, Jianhao, Huang, Xiulu, Wei, Fenglian, Yu, Yanqing, Huang, Litian, Zhang, Wenjiao, Tang, Meizhu, Deng, Licai, Han, Jiaxia, Zhou, Xing, Wang, Qiu, Lu, Wensheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797935/
https://www.ncbi.nlm.nih.gov/pubmed/35673930
http://dx.doi.org/10.1111/iwj.13861
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author Zhang, Li
Fu, Guifen
Deng, Yongqing
Nong, Yuechou
Huang, Jianhao
Huang, Xiulu
Wei, Fenglian
Yu, Yanqing
Huang, Litian
Zhang, Wenjiao
Tang, Meizhu
Deng, Licai
Han, Jiaxia
Zhou, Xing
Wang, Qiu
Lu, Wensheng
author_facet Zhang, Li
Fu, Guifen
Deng, Yongqing
Nong, Yuechou
Huang, Jianhao
Huang, Xiulu
Wei, Fenglian
Yu, Yanqing
Huang, Litian
Zhang, Wenjiao
Tang, Meizhu
Deng, Licai
Han, Jiaxia
Zhou, Xing
Wang, Qiu
Lu, Wensheng
author_sort Zhang, Li
collection PubMed
description This study aimed to explore the risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis (DFO) and diabetic nephropathy (DN). This is a prospective cohort study. Between May 2018 and May 2021, we selected 120 inpatients with comorbid severe diabetic foot infection (PEDIS Grade 3 or above) and DN for inclusion in our study. All cases were followed up for 36 months. The study outcomes were whether foot ulcer recurred and the time to recurrence. The risk factors of ulcer recurrence were analysed by comparing the data of the three groups. According to the recurrence of foot ulcer, the participants were divided into three groups: Group A (no foot ulcer recurrence, n = 89), Group B (foot ulcer recurrence within 12‐36 months, n = 19) and Group C (foot ulcer recurrence within 6‐12 months, n = 12). The multivariate Cox regression analysis showed that urine albumin‐creatinine ratio (UACR) (HR: 1.008, 95% CI: 1.005‐1.011, P < .001) and vibration perception threshold (VPT) (HR: 1.064, 95% CI: 1.032‐1.096, P < .001) were identified as independent risk factors. Kaplan‐Meier curves showed a significant positive association between UACR or VPT and the risk of foot ulcer recurrence (log rank, all P < .05). Areas under the ROC curves for UACR, VPT and the combination of UACR and VPT were 0.802, 0.799 and 0.842, respectively. The best cut‐off values of UACR and VPT were 281.51 mg/g and 25.12 V, respectively. In summary, elevated UACR and VPT were independent risk factors. The best clinical cut‐off values of UACR and VPT for prediction of foot ulcer recurrence were 281.51 mg/g and 25.12 V, respectively. Besides, our results suggested that microcirculation disorders rather than macrovascular complications play a major role in the recurrence of foot ulcer in patients with comorbid DFO and DN.
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spelling pubmed-97979352023-01-05 Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study Zhang, Li Fu, Guifen Deng, Yongqing Nong, Yuechou Huang, Jianhao Huang, Xiulu Wei, Fenglian Yu, Yanqing Huang, Litian Zhang, Wenjiao Tang, Meizhu Deng, Licai Han, Jiaxia Zhou, Xing Wang, Qiu Lu, Wensheng Int Wound J Original Articles This study aimed to explore the risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis (DFO) and diabetic nephropathy (DN). This is a prospective cohort study. Between May 2018 and May 2021, we selected 120 inpatients with comorbid severe diabetic foot infection (PEDIS Grade 3 or above) and DN for inclusion in our study. All cases were followed up for 36 months. The study outcomes were whether foot ulcer recurred and the time to recurrence. The risk factors of ulcer recurrence were analysed by comparing the data of the three groups. According to the recurrence of foot ulcer, the participants were divided into three groups: Group A (no foot ulcer recurrence, n = 89), Group B (foot ulcer recurrence within 12‐36 months, n = 19) and Group C (foot ulcer recurrence within 6‐12 months, n = 12). The multivariate Cox regression analysis showed that urine albumin‐creatinine ratio (UACR) (HR: 1.008, 95% CI: 1.005‐1.011, P < .001) and vibration perception threshold (VPT) (HR: 1.064, 95% CI: 1.032‐1.096, P < .001) were identified as independent risk factors. Kaplan‐Meier curves showed a significant positive association between UACR or VPT and the risk of foot ulcer recurrence (log rank, all P < .05). Areas under the ROC curves for UACR, VPT and the combination of UACR and VPT were 0.802, 0.799 and 0.842, respectively. The best cut‐off values of UACR and VPT were 281.51 mg/g and 25.12 V, respectively. In summary, elevated UACR and VPT were independent risk factors. The best clinical cut‐off values of UACR and VPT for prediction of foot ulcer recurrence were 281.51 mg/g and 25.12 V, respectively. Besides, our results suggested that microcirculation disorders rather than macrovascular complications play a major role in the recurrence of foot ulcer in patients with comorbid DFO and DN. Blackwell Publishing Ltd 2022-06-08 /pmc/articles/PMC9797935/ /pubmed/35673930 http://dx.doi.org/10.1111/iwj.13861 Text en © 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Zhang, Li
Fu, Guifen
Deng, Yongqing
Nong, Yuechou
Huang, Jianhao
Huang, Xiulu
Wei, Fenglian
Yu, Yanqing
Huang, Litian
Zhang, Wenjiao
Tang, Meizhu
Deng, Licai
Han, Jiaxia
Zhou, Xing
Wang, Qiu
Lu, Wensheng
Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title_full Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title_fullStr Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title_full_unstemmed Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title_short Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3‐year follow‐up study
title_sort risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: a 3‐year follow‐up study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797935/
https://www.ncbi.nlm.nih.gov/pubmed/35673930
http://dx.doi.org/10.1111/iwj.13861
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