Abstract
Background
One of the most serious complications of diabetes mellitus (DM) is a diabetic foot ulcer (DFU), with lower extremity amputation (LEA).
Aims
This study aims to explore the role of anxiety and depression on mortality, reamputation and healing, after a LEA due to DFU.
Methods
A sample of 149 patients with DFU who underwent LEA answered the Hospital Anxiety and Depression Scale and a sociodemographic and clinical questionnaire. This is a longitudinal and multicenter study with four assessment moments that used Cox proportional hazards models adjusted for demographic and clinical variables.
Results
Rate of mortality, reamputation and healing, 10 months after LEA were 9.4%, 27.5% and 61.7%, respectively. Anxiety, at baseline, was negatively associated with healing. However, depression was not an independent predictor of mortality. None of the psychological factors was associated with reamputation.
Conclusion
Results highlight the significant contribution of anxiety symptoms at pre-surgery, to healing after a LEA. Suggestions for psychological interventions are made.
Acknowledgements
The authors gratefully acknowledge the contributions of the Multidisciplinary Diabetic Foot Clinics of five hospitals: Centro Hospitalar Universitário do Porto, Centro Hospitalar Vila Nova de Gaia/Espinho, Centro Hospitalar Tâmega e Sousa, Unidade Local de Saúde do Alto Minho, Vascular Surgery Department of Centro Hospitalar de São João and Vascular Surgery Department and Physical Medicine and Rehabilitation Department of Hospital de Braga. The authors also wish to thank all patients who agreed to participate in this study.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all participants included in this study.
Disclosure statement
No potential conflict of interest was reported by the author(s).