1. Diabetic foot disease carries an intrinsic high risk of mortality and other severe outcomes in type 2 diabetes: a propensity score-matched retrospective population-based study.
- Author
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Vlacho B, Bundó M, Llussà J, Real J, Mata-Cases M, Cos X, Tundidor D, Zaccardi F, Khunti K, Jude EB, Franch-Nadal J, and Mauricio D
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Risk Factors, Aged, Incidence, Risk Assessment, Time Factors, Prognosis, Cause of Death, Cardiovascular Diseases mortality, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Severity of Illness Index, Diabetes Mellitus, Type 2 mortality, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 epidemiology, Diabetic Foot mortality, Diabetic Foot diagnosis, Diabetic Foot epidemiology, Amputation, Surgical mortality, Propensity Score
- Abstract
Background: To evaluate the association between diabetic foot disease (DFD) and the incidence of fatal and non-fatal events in individuals with type 2 diabetes (T2DM) from primary-care settings., Methods: We built a cohort of people with a first DFD episode during 2010-2015, followed up until 2018. These subjects were 1 to 1 propensity score matched to subjects with T2DM without DFD. The incidence of all-cause mortality, the occurrence of new DFD, amputations, cardiovascular diseases, or composite outcome, including all-cause mortality and/or cardiovascular events during the follow-up period, were calculated. A Cox proportional hazard analysis was conducted to evaluate the hazard ratios (HR) for different events., Results: Overall, 11,117 subjects with T2DM with a first episode of DFD were compared with subjects without DFD. We observed higher incidence rates (IRs) for composite outcome (33.9 vs. 14.5 IR per 100 person-years) and a new DFD episode event (22.2 vs. 1.1 IR per 100 person-years) in the DFD group. Compared to those without DFD, those with a first episode of DFD had a higher HR for all events, with excess rates particularly for amputation and new DFD occurrence (HR: 19.4, 95% CI: 16.7-22.6, HR: 15.1, 95% CI: 13.8-16.5, respectively) was found., Conclusions: Although DFD often coexists with other risk factors, it carries an intrinsic high risk of morbidity and mortality in individuals with T2DM. DFD should be regarded as a severe complication already at its onset, as it carries a poor clinical prognosis., (© 2024. The Author(s).)
- Published
- 2024
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