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The clinical course and mortality of persons with diabetic Charcot foot
Susanne Engberg, Henrik Ullits Andersen, Anne Rasmussen
1kkm@dadlnet.dk.
Insights
Diabetic Charcot foot patients have a 4.6/person-year mortality rate, unaffected by smoking, diabetes type, or HbA1c. Diagnosis delays and complications are common in Charcot foot cases.
Area of Science:
- Diabetology
- Podiatry
- Vascular Surgery
Background:
- Diabetic Charcot foot is a serious complication of diabetes mellitus.
- Understanding its mortality and clinical course is crucial for patient management.
Purpose of the Study:
- To investigate the mortality rate associated with diabetic Charcot foot.
- To analyze the clinical course and outcomes of patients diagnosed with diabetic Charcot foot.
Main Methods:
- Retrospective cohort study of diabetic patients diagnosed with Charcot foot between 2000 and 2016.
- Mortality sub-study included 164 patients; clinical course sub-study included 114 patients.
Main Results:
- Mortality rate was 4.6 per 100 person-years at risk, not significantly influenced by smoking, diabetes type, duration, or HbA1c.
- 85% of patients had active Charcot foot; diagnosis delay averaged ten weeks.
- 40% developed rocker bottom deformities; treatment duration averaged 7.5 months.
Conclusions:
- Diabetic Charcot foot carries a significant mortality risk, independent of common risk factors.
- Delayed diagnosis and prolonged treatment are characteristic of the condition, often leading to complications.
Introduction:
The aim was to study the mortality and the clinical course of diabetic Charcot foot.
Methods:
This was a retrospective cohort study including all persons with diabetes and a Charcot diagnosis from 2000 to 2016.
Results:
In the mortality sub-study, 164 persons had the Charcot diagnosis, 52 (31.1%) died in the follow-up period. The mortality rate was 4.6/100 person-years at risk. Rate ratios for death were insignificantly different among smokers and non-smokers, among persons with type 1 and type 2 diabetes, among persons with a diabetes duration below or above ten years and among persons with a glycated haemoglobin (HbA1c) level above or below 60 mmol/mol after adjustment for age and gender. In the clinical course sub-study, 114 persons with Charcot were identified whereof 97 (85%) had an active Charcot. The duration from start of symptoms to diagnosis was ten weeks, the treatment period was 7.5 months and 46 (40%) had bony prominences (rocker bottom) in the planta at follow-up.
Conclusions:
The mortality rate among persons with Charcot was 4.6/person-years at risk, which was unaffected by smoking, diabetes type, diabetes duration and HbA1c level. The persons with Charcot had a long delay from symptom onset to diagnosis, a long treatment period and often developed complications.
Funding:
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Trial Registration:
not relevant.
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