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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Frailty Is Associated with Impaired Diabetic Foot Ulcer Healing and All-Cause Re-Hospitalization.

G Maltese1, G Basile, H Meehan

  • 1Dr Giuseppe Maltese, School of Cardiovascular Medicine and Sciences, Faculty of Life Sciences, King's College London, 150 Stamford Street, London SE1 9NH, UK, Email: giuseppe.maltese@kcl.ac.uk, Twitter: @docmaltese.

The Journal of Nutrition, Health & Aging
|February 15, 2022
PubMed
Summary

Frailty significantly increases the risk of Diabetic Foot Ulcers (DFUs) not healing and leads to higher re-hospitalization rates. Comprehensive frailty assessment is crucial for personalized DFU management.

Keywords:
Diabetic foot ulcersdiabetesfrailtyoutcomes

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Area of Science:

  • Gerontology
  • Diabetology
  • Vascular Surgery

Background:

  • Diabetic Foot Ulcers (DFUs) are a severe complication of diabetes, often involving complex patient factors like multimorbidity and frailty.
  • Frailty, a predictor of adverse health outcomes, has not been previously studied in relation to DFU healing and hospitalization.
  • This study investigates the impact of frailty on DFU outcomes in hospitalized patients.

Purpose of the Study:

  • To determine the prevalence of frailty in hospitalized patients with DFUs.
  • To examine the association between frailty and DFU non-healing.
  • To assess the relationship between frailty and re-hospitalization rates within six months post-discharge.

Main Methods:

  • A prospective cohort study was conducted with 76 hospitalized patients diagnosed with DFUs.
  • Frailty status was assessed using the Frailty Index (FI), with FI > 0.25 defining frailty.
  • Primary outcome was DFU non-healing; secondary outcome was re-hospitalization within 6 months.

Main Results:

  • Frailty was highly prevalent, affecting 74% of the 76 patients.
  • Frail patients had significantly higher rates of DFU non-healing (81.5% vs. 55%) and re-hospitalization (90.3% vs. 54%) at six months.
  • Frailty independently predicted a more than fivefold increased risk of DFU non-healing (OR 5.54).

Conclusions:

  • Frailty is common in hospitalized DFU patients and is an independent risk factor for poor healing and increased re-hospitalization.
  • A thorough frailty assessment is essential for tailoring management strategies for patients with DFUs.
  • Personalized interventions based on frailty status can potentially improve outcomes for DFU patients.