Cumulative long-term recurrence of diabetic foot ulcers in two cohorts from centres in Germany and the Czech Republic
| Autor: | Katherine Ogurtsova, Michal Dubský, Dan Ziegler, Alexandra Jirkovská, Andrea Icks, Gerhard Rümenapf, Stephan Morbach, Burkhard Haastert |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Cohort Studies 03 medical and health sciences 0302 clinical medicine Endocrinology Recurrence Risk Factors Germany Diabetes mellitus Internal medicine Internal Medicine medicine Humans Cumulative incidence Prospective Studies 030212 general & internal medicine Renal replacement therapy Aged Czech Republic Aged 80 and over business.industry Proportional hazards model Incidence Incidence (epidemiology) General Medicine Middle Aged medicine.disease Diabetic foot Diabetic Foot Diabetic foot ulcer Diabetes Mellitus Type 2 Amputation Female business |
| Zdroj: | Diabetes Research and Clinical Practice. 172:108621 |
| ISSN: | 0168-8227 |
| Popis: | Aims Our aim was to comprehensively estimate the incidence of diabetic foot ulcer (DFU) recurrence and corresponding risk factors in two cohorts. Methods Prospective data from patients with active DFU from two diabetes centres in Germany (GER, n = 222) and the Czech Republic (CZ, n = 99) were analysed. Crude cumulative incidences were obtained. Additionally, time to recurrence and risk factors were investigated using multivariate Cox models. Results 69%(154) of patients in GER and 70%(69) in CZ experienced at least one DFU recurrence; 25%(56) in DEU and 15%(15) in CZ died; 5%(11) and 9%(9) were lost to follow-up. The crude cumulative incidence in the first year was 28% in GER and 25% in CZ; 68%/70% within ten years, and 69%/70% in 15 years. In GER, renal replacement therapy was associated with shorter time to recurrence (HR = 3.71, 95%CI:1.26–10.87); no history of DFU before the index lesion with longer time to recurrence (HR = 0.62, 0.42–0.92). In CZ, type 2 diabetes (HR = 2.57, 1.18–5.62) and index ulcer treatment by minor amputation (HR = 2.11, 1.03–4.33) were associated with shorter time to recurrence. Conclusions Cumulative DFU recurrence was approximately 70% in 15 years in both cohorts. We found a significantly higher risk of future recurrence in patients having a consecutive ulcer compared with the first ever ulcer. |
| Databáze: | OpenAIRE |
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