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Impact of heart failure and dialysis in the prognosis of diabetic patients with ischemic foot ulcers
- Source :
- Journal of Clinical & Translational Endocrinology, Journal of Clinical & Translational Endocrinology, Vol 11, Iss, Pp 31-35 (2018)
- Publication Year :
- 2017
-
Abstract
- Aim To establish the role of heart failure (HF) and dialysis (D) in the prognosis of diabetic patients with critical limb ischemia and foot ulcers (FUs). Methods Consecutive diabetic patients with ischemic FUs who referred to our Diabetic Foot Centre were prospectively included. All patients underwent a preset limb salvage protocol including peripheral revascularization. According to the presence of HF and D, they were divided in four groups: group 1 without HF and without D defined as ischemic foot (IF); group 2 with HF and without D defined as heart ischemic foot (H-IF); group 3 without HF and with D defined as renal ischemic foot (R-IF); group 4 with HF and with dialysis defined as heart-renal foot (HR-IF). Survival with limb salvage, survival with major amputation and death were reported after 1 year of follow-up. Results 136 patient have been included: 66 with IF, 26 with H-IF, 24 with R-IF and 20 with HR-IF. The mean age was 68,9 ± 9,7 years, the diabetes duration 20,7 ± 11,6 years, the mean HbA1c 62,7 ± 22,3 mmol/mol. 103/136 (75,7%) survived with limb salvage, 10/136 (7,4%) survived with major amputation, 23/136 (16,9%) died. The outcomes for group IF patients, H-IF, R-IF and HR-IF were respectively: survival with limb salvage (92,4%, 61,5%, 79,2% and 35%), survival with major amputation (6,1%, 7,7%, 8,3% and 10%), death (1,5%, 30,8%, 12,5% and 55%) χ = 0.0001. Heart failure was an independent predictor of death. Discussion The presence of heart failure and dialysis in diabetic patients with ischemic foot ulcers was associated to high risk of amputation and mortality.
- Subjects :
- medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Revascularization
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Settore MED/13 - Endocrinologia
Ischemic foot
03 medical and health sciences
0302 clinical medicine
Endocrinology
medicine
Dialysis
lcsh:RC648-665
business.industry
Critical limb ischemia
medicine.disease
Diabetic foot
Surgery
Amputation
Heart failure
medicine.symptom
business
Foot (unit)
Research Paper
Subjects
Details
- ISSN :
- 22146237
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of clinicaltranslational endocrinology
- Accession number :
- edsair.doi.dedup.....9e207910284882b1b5723590dc216c27