Predictors of Diabetic Foot Reulceration beneath the Hallux
Autor: | R. J. Molines-Barroso, J. L. Lázaro-Martínez, J. V. Beneit-Montesinos, F. J. Álvaro-Afonso, E. García-Morales, Y. García-Álvarez |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: | |
Zdroj: | Journal of Diabetes Research, Vol 2019 (2019) |
Druh dokumentu: | article |
ISSN: | 2314-6745 2314-6753 |
DOI: | 10.1155/2019/9038171 |
Popis: | Aims. To evaluate the factors that predict reulceration beneath the hallux in people with a history of diabetic foot ulceration. Methods. A prospective study conducted between January 2012 and December 2014 was performed in a diabetic foot unit to assess the risk factors associated with hallux reulceration. Sixty patients with diabetic neuropathy and a history of previous ulcer were consecutively included. Sociodemographic factors and comorbidities plus the biomechanical and radiographic factors were obtained. Follow-up on participants was conducted every month, and they wore offloading therapeutic footwear and custom-made insoles. Hallux reulceration during the follow-up period was assessed as the main outcome measure in the study. Results. Patients were followed up during 29 (14.2-64.4) months. Twenty-nine patients (52%) developed a new ulceration: 9 patients (31%) in the hallux and 20 (69%) in other locations. Functional hallux limitus (p=0.005, 95% CI (2.097–73.128), HR 12.384) and increased body mass index (p=0.044, 95% CI (1.003-1.272), HR 1.129) were associated with the hallux ulceration-free survival time in the multivariate Cox model. Conclusions. Obesity and the presence of functional hallux limitus increase the probability of developing hallux reulceration in patients with diabetic neuropathy and a history of ulcers. |
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