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In blood we trust: anemia as a negative healing prognostic factor in diabetic foot patients
Francesco Giangreco1, Elisabetta Iacopi1, Vittorio Malquori1
1Diabetic Foot Section - Pisa University Hospital, Via Paradisa 2, 56126, Pisa, Italy.
Insights
Anemia significantly impacts diabetic foot healing. Patients with anemia showed lower healing rates and higher recurrence rates, indicating anemia is an independent predictor of healing failure in diabetic foot disease.
Area of Science:
- Diabetology
- Hematology
- Vascular Surgery
Background:
- Diabetic foot (DF) disease severity is linked to anemia.
- Anemia's impact on DF healing outcomes requires further investigation.
Purpose of the Study:
- To assess if anemia presence affects healing rates in diabetic foot patients.
- To evaluate the relationship between anemia and diabetic foot healing outcomes, including healing time and recurrence rates.
Main Methods:
- Retrospective analysis of 196 diabetic foot patients admitted in 2021.
- Patients were divided into two groups: with anemia (Group A) and without anemia (Group B).
- Comparison of clinical characteristics, procedures, and outcomes: healing rate (HR) at 6 months, healing time (HT), and recurrence rate (RR) at 12 months.
Main Results:
- Anemia was present in 58% of patients (Group A), who had longer disease duration and lower hemoglobin/red blood cell counts.
- Group A exhibited a significantly lower healing rate (55.2% vs. 76.8%, p=0.0028) and higher recurrence rate (23.6% vs. 17.1%, p<0.02).
- Anemia was confirmed as an independent predictor of healing failure (Hazard Ratio 2.8, p=0.0037).
Conclusions:
- Anemia is a common comorbidity in diabetic foot patients.
- Anemia is associated with reduced healing chances and increased recurrence rates in diabetic foot disease.
- Anemia represents an independent predictor of healing failure in diabetic foot patients.
Aim:
Anemia has been associated with severity of diabetic foot (DF) disease. Our study aimed to evaluate whether the presence of anemia could decrease the healing chances in DF.
Methods:
We retrospectively analyzed all patients admitted in our department in 2021 for DF, dividing them according to presence (Group A) or absence (Group B) of anemia. Groups were compared for clinical and demographic characteristics, procedures and outcomes: healing rate (HR) at 6 months, healing time (HT) and recurrence rate (RR) at 12 months.
Results:
We sorted out data from 196 consecutive patients: 114 (58%) in Group A and 82 (42%) in B. Group A had a higher male prevalence and a longer duration of disease. Group A showed lower hemoglobin concentration (10.3 ± 1.3 g/dL vs 13.1 ± 1.4 g/dL, p < 0.002) and red blood cells count (3.4 ± 0.5 × 106/mL vs 4.8 ± 0.6 × 106/mL, p = 0.004). Group A presented a lower HR (55.2% vs 76.8%, p = 0.0028), no differences in HT and a higher RR (23.6% vs 17.1%, p < 0.02). Cox's logistic regression on healing confirmed the negative impact of anemia: hazard ratio 2.8 (CI 95% 1.4-5.4, p = 0.0037).
Conclusions:
Anemia is frequent in DF and associates to a reduction in healing chances and an increase in recurrences representing an independent predictor of healing failure.
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