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Risk of Venous Thromboembolism in People Affected by Charcot Foot Treated With Total Contact Cast
Johan Schoug1,2, Per Katzman1,2, Erik Uddman1,2
1Department of Endocrinology, Skåne University Hospital, Lund, Sweden.
Aims:
Charcot Foot (CF) is a neuropathy-induced condition that can lead to fractures and dislocation, warranting long-time offloading in total contact cast (TCC). It is unknown whether CF or its treatment increases the risk of venous thromboembolism (VTE). This study aims to retrospectively investigate the risk of VTE in people with CF during and after treatment.
Methods:
Individuals with diabetes mellitus and active CF treated with TCC at Skåne University Hospital (Lund and Malmö, Sweden) were screened for inclusion in a retrospective cohort study. Baseline characteristics and occurrences of VTE were retrieved using medical records. Causes of death were retrieved from the National Cause of Death Register.
Results:
209 individuals with 241 CF episodes were included and followed for 6.8 (3.8-11) years. No VTE was diagnosed during TCC treatment. Two individuals (0.96%) developed VTE after uncasting but before discharge (86-157 days after uncasting; while using boot and orthotic walker, respectively), whereas the other eight individuals (3.8%) had VTE diagnosed after end of CF treatment and follow-up. Hemodialysis was associated with increased VTE risk after CF diagnosis (HR 13 [3.25-50], p < 0.001, accounting for all observed VTE occurrences).
Conclusion:
No VTE occurred during TCC treatment, whereas the risk of VTE during the entire CF treatment period was 0.96%.
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