title: Long-term outcome and disability of diabetic patients hospitalized for diabetic foot ulcers: a 6.5-year follow-up study.
abstract: OBJECTIVE
  The long-term outcome and functional status of subjects hospitalized for diabetic foot ulcers have been poorly studied and thus are the topics of this study.
  
  
  METHODS
  Ninety-four consecutive diabetic subjects hospitalized for diabetic foot ulcers between January 1998 and December 2000 were prospectively followed for mean +/- SD 79.5 +/- 13.3 months. We calculated rates of primary healing, new ulcers, amputations, mortality, and disability and evaluated the global therapeutic success (GTS) of foot care management as defined by the association of primary healing without recurrence or disability at the end of follow-up.
  
  
  RESULTS
  Follow-up was successful in 89 of 94 subjects (63 men and 31 women; age 63.7 +/- 10.8 years). Of these, 69 (77.5%) experienced primary healing without major amputation, 39 (43.8%) underwent amputation (24 minor and 15 major), and 46 died (51.7%), including 23 from cardiovascular events. Forty-two of 69 patients who experienced primary healing (60.9%) had ulcer recurrence. At the end of the follow-up period, 25 patients (28.1%) were dependent and 40 subjects (44.9%) had achieved GTS. Multivariate analysis showed the role of age as an independent predictor of GTS (P < 0.05) and of impaired renal function/albuminuria as independent predictors of healing failure, first amputation, and mortality (P < 0.01).
  
  
  CONCLUSIONS
  Despite a satisfactory initial healing rate, the global long-term outcome of patients hospitalized for diabetic foot ulcers was poor. Nephropathy appears to be an important predictor of long-term outcome. Further studies are needed to establish recognized criteria for therapeutic success going beyond just the evaluation of healing rate in the management of diabetic foot ulcers.
authors.affiliation: Le Centre Hospitalier Universitaire Montpellier, Montpellier, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Ghanassia
authors.forename: Laetitia
authors.initials: L
authors.lastname: Villon
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Thuan Dit Dieudonné
authors.forename: Catherine
authors.initials: C
authors.lastname: Boegner
authors.forename: Antoine
authors.initials: A
authors.lastname: Avignon
authors.forename: Ariane
authors.initials: A
authors.lastname: Sultan
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D017719:Diabetic Foot / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014945:Wound Healing