title: Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients.
abstract: OBJECTIVE
  Peripheral vascular disease (PVD) is an important limiting factor for healing in neuroischemic or ischemic diabetic foot ulcer. The purpose of this study was to identify factors related to healing in patients with diabetes with foot ulcers and severe PVD.
  
  
  METHODS
  Patients with diabetes with a foot ulcer, consecutively presenting at a multidisciplinary foot center with a systolic toe pressure <45 mm Hg or an ankle pressure <80 mm Hg were prospectively included, followed according to a preset program, and with the exception of specified exclusions, subjected to angiography offered vascular intervention when applicable. All patients had continuous follow-up until healing or death irrespective of the type of vascular intervention.
  
  
  RESULTS
  One thousand one hundred fifty-one patients were included. Eighty-two percent had a toe pressure <45 mm Hg and 49% had an ankle pressure <80 mm Hg. Eight hundred one patients (70%) underwent an angiography. Out of these, 63% had vascular intervention, either percutaneous transluminal angioplasty (PTA; 39%) or reconstructive surgery (24%). Nine percent of the patients had one or more complications after angiography. PTA was multisegmental in 46% and to the crural arteries in 46%. Reconstructive surgery was distal in 51%. Age (P < .001), renal function impairment (P = .005), congestive heart failure (P = .01), number and type of ulcer (P < .001), and severity of PVD (P = .003) affected the outcome of ulcers. PTA and reconstructive vascular surgery increased the probability of healing without amputation (odds ratio [OR], 1.77 and 2.05, respectively).
  
  
  CONCLUSIONS
  Probability of ulcer healing is strongly related to comorbidity, extent of tissue involvement, and severity of PVD in patients with diabetes with severe PVD.
authors.affiliation: Department of Endocrinology, Skåne University Hospital, Lund University, Malmö, Sweden. Targ.Elgzyri@med.lu.se
authors.forename: Jan
authors.initials: J
authors.lastname: Apelqvist
authors.forename: Targ
authors.initials: T
authors.lastname: Elgzyri
authors.forename: Jan
authors.initials: J
authors.lastname: Larsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Löndahl
authors.forename: Per
authors.initials: P
authors.lastname: Nyberg
authors.forename: Johan
authors.initials: J
authors.lastname: Thörne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000503:physiopathology / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D016523:Foot Ulcer / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing