Mortality rates in people presenting with a new diabetes-related foot ulcer: a cohort study with implications for management
Authors' conclusion
Short-term mortality rates in people with a DFU is high. Teams managing people with DFUs should consider modifying the burdensome interventions and care required to heal such ulcers so maximising the quality of residual life, rather than focusing exclusively on healing.
Study context
- Population
- People with a new DFU registered by a specialist diabetes footcare service in the NDFA in England and Wales, April 2017–March 2022
- Participants
- 71,000 people
- Outcome
- Mortality rates
- Follow-up
- 12, 26 and 52 weeks
Methodological detailsregistry-based (National Diabetes Foot Care Audit), Poisson regression
- Registry-based (National Diabetes Foot Care Audit)
- Poisson regression
Main finding
As reported in the abstract
Mortality rate
Mortality at 12 weeks
4.2%
Mortality at 26 weeks
8.2%
Mortality at 52 weeks
14.4%
Observational data: associations, not effects.
Further findings
| Outcome | Rate ratio (95% CI) | |
|---|---|---|
| Risk factors for higher mortality (rate ratios) · 26 weeksAge ≥80 yearsvs Age 65-79 years | 2.15 (2.03–2.28) | |
| 0.512Rate ratio (log scale) |
- Risk factors for higher mortality (rate ratios) — Ulcer area ≥1 cm², rate ratio
- 1.50 (1.42, 1.59) (95% CI)
- Risk factors for higher mortality (rate ratios) — Deep ulcers, rate ratio
- 1.26 (1.18, 1.35) (95% CI)
- Risk factors for higher mortality (rate ratios) — Hindfoot location, rate ratio
- 1.53 (1.44, 1.62) (95% CI)
- Risk factors for higher mortality (rate ratios) — Recorded evidence of lower-limb ischaemia, rate ratio
- 1.78 (1.69, 1.88) (95% CI)
- Risk factors for higher mortality (rate ratios) — HF, rate ratio
- 2.13 (2.00, 2.26) (95% CI)
- Risk factors for higher mortality (rate ratios) — MI, rate ratio
- 1.45 (1.29, 1.63) (95% CI)
- Risk factors for higher mortality (rate ratios) — Stroke, rate ratio
- 1.37 (1.22, 1.53) (95% CI)
- Risk factors for higher mortality (rate ratios) — Renal replacement therapy, rate ratio
- 2.34 (2.09, 2.61) (95% CI)
- Risk factors for higher mortality (rate ratios) — CKD stage 3 or greater, rate ratio
- 1.20 (1.12, 1.29) (95% CI)
Individuals with 26-week mortality rate >25%
- All individuals
- 7.3%
- Aged 65 years and older
- 11.5%
- Aged 80 years and over
- 22.1%
Original publication
Mortality rates in people presenting with a new diabetes-related foot ulcer: a cohort study with implications for management. Diabetologia. Published 27 September 2024. doi:10.
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