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Increased mortality associated with diabetic foot ulcer

E J Boyko1, J H Ahroni, D G Smith

  • 1Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA.

Diabetic Medicine : a Journal of the British Diabetic Association
|November 1, 1996
PubMed
Summary

Diabetic veterans with foot ulcers face a significantly higher risk of short-term death. This study highlights the critical link between diabetic foot complications and mortality, emphasizing the need for further research into underlying causes.

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Area of Science:

  • Medical Research
  • Diabetology
  • Vascular Health

Background:

  • Diabetes mellitus is a prevalent condition, particularly among veteran populations.
  • Diabetic foot ulcers are a serious complication, associated with increased morbidity and mortality.
  • Understanding risk factors for mortality in diabetic patients is crucial for improving outcomes.

Purpose of the Study:

  • To investigate the association between foot ulceration and short-term mortality in American military veterans with diabetes mellitus.
  • To quantify the risk of death associated with foot ulcer development in this cohort.
  • To explore potential contributing factors to mortality in diabetic veterans with lower extremity complications.

Main Methods:

  • Prospective cohort study involving 725 diabetic subjects from 1990-1994.

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  • Follow-up duration averaged 691.8 days to assess mortality events.
  • Statistical analyses included relative risk calculations and Cox regression, adjusting for multiple covariates.

    • Main Results:

    • Foot ulceration was associated with a 2.39-fold increased relative risk of death (95% CI 1.13-4.58).
    • The mortality risk was 12.1 per 100 person-years for those with foot ulcers versus 5.1 for those without.
    • Higher ankle-arm index correlated with reduced mortality risk, independent of ulcer status.

    Conclusions:

    • Foot ulceration and lower extremity vascular disease are significant predictors of increased short-term mortality in diabetic veterans.
    • The findings underscore the importance of managing diabetic foot complications to mitigate mortality risk.
    • Further research is warranted to elucidate the mechanisms driving this excess mortality.