Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies
Authors' conclusion
This meta-analysis found that the overall mortality of DFU was high, with nearly 50% mortality within 5 years. Cardiovascular disease and infection were the two leading causes of death.
Study context
- Population
- Patients with diabetic foot ulcer (DFU); observational studies reporting long-term mortality, searched 1 January 2011 to 31 July 2022; 16 countries
- Participants
- 124,376 patients34 studies
- Outcome
- Long-term survival of patients with DFU
Methodological detailsrandom effect models, reconstructed participant data from Kaplan-Meier curves, aggregate data meta-analysis
- Random effect models
- Reconstructed participant data from Kaplan-Meier curves
- Aggregate data meta-analysis
Pooled result
As reported in the abstract
Kaplan-Meier-based survival rates
Survival at 1 year
86.9%
95% CI 82.6%–91.5%
Survival at 3 years
66.9%
95% CI 59.3%–75.6%
Survival at 5 years
50.9%
95% CI 42.0%–61.7%
Survival at 10 years
23.1%
95% CI 15.2%–34.9%
Further pooled results
Deaths
- Deaths among 124 376 participants
- 51 386
Aggregate data-based meta-analysis
- Results similar to Kaplan-Meier-based meta-analysis
Causes of death
- CVD
- 46.6% (95% CI 33.5%-59.7%)
- Infection
- 24.8% (95% CI 16.0%-33.5%)
Risk factors for mortality
- Older age (per 1 year), HR
- 1.054 (95% CI 1.045-1.063)
- Peripheral artery disease, HR
- 1.882 (95% CI 1.592-2.225)
- CKD, HR
- 1.535 (95% CI 1.227-1.919)
- End-stage renal disease, HR
- 3.586 (95% CI 1.333-9.643)
- Amputation, HR
- 2.415 (95% CI 1.323-4.408)
- History of CVD, HR
- 1.449 (95% CI 1.276-1.645)
- Higher mortality risk
Original publication
Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies. Diabetes Obes Metab. Published 4 September 2022. doi:10.
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