Prognosis of the outcome of severe diabetic foot ulcers with multidisciplinary care

Abstract

Background: Approximately 2–4% of individuals worldwide with diabetes mellitus have foot ulcers. This study aims to assess the factors affecting the outcomes of severe foot ulcers in diabetic individuals.

Methods: An analytical prospective cohort study was conducted from March 1st, 2015, to March 1st, 2017. A total of 34 individuals was selected. The study included patients with foot ulcers below the ankle who were at risk of amputation. All tests used a <5% level of significance and confidence interval of 95%. A Pearson’s chi-squared test and binary multiple regression were performed to assess the factors related to healing.

Results: Only 11.7% of the individuals required amputation; ulcers classified as 2/B according to the University of Texas Diabetic Foot Ulcer Classification System healed before the 1/B ulcers. Neuropathic ulcers were the most prevalent (58.8%); 61.8% healed after 1 year. Most of the individuals were overweight, 47.1% had reduced glomerular filtration rates, and 78.8% had glycated hemoglobin >7%. Body mass index and osteomyelitis were the two significant variables in logistic regression.

Conclusions: In this study, osteomyelitis was the main complication related to the risk of amputation, and elevated body mass index and osteomyelitis were the significant factors that induced a slower healing time.

Keywords:

• diabetes mellitus
• diabetic foot
• diabetes complications
• multidisciplinary care

Acknowledgments

The authors are grateful to the co-workers and all involved of the Regional Hospital of Asa Norte and Dra. Hermelinda Pedrosa for the contribution in the work of diabetic foot in Brazil. This research was funded by Fundation of Health Science Teaching and Research (FEPECS).

Author contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.