title: Factors associated with calcification in the pedal arteries in patients with diabetes and neuropathy admitted for foot disease and its clinical significance.
abstract: The aim of this study was to determine the factors associated with calcification in the pedal arteries (CPAs) in a population of patients with diabetes admitted for acute foot disease and to find whether the presence of CPAs had any influence on the short-term outcomes. Electronic charts were retrospectively reviewed for patients admitted to our department for acute diabetic foot problems between January 1, 2008, and December 31, 2012. Digital images of the plain x-rays, which were performed on patients during this period, were reviewed. Patients were classified into 2 groups: those with absence (group 1) and presence of CPAs (group 2). One hundred and sixty-five patients were included in the present study. Ninety-eight (59.4%) patients had CPAs in the plain x-rays. The predictive variables related to the presence of CPAs were duration of diabetes >20 years (odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.0-4.3), retinopathy (OR = 2.2, 95% CI = 1.0-4.6), albuminuria (OR = 3.3, 95% CI = 1.5-7.4), and peripheral arterial disease (OR = 4.2, 95% CI = 2.0-8.7). Fifty-six patients underwent amputation (33.9%): 13 (19.4%) in group 1 and 43 (43.9%) in group 2 (P < .01). Thirty-four patients (20.6) required reoperation: 6 (9%) in group 1 and 28 (28.6%) in group 2 (P < .01). In conclusion, the predictive variables related to the presence of CPAs in a series of patients admitted for foot disease were duration of diabetes >20 years, retinopathy, albuminuria, and peripheral arterial disease. Differences in the outcomes were related to the association of CPAs with peripheral arterial disease.
authors.affiliation: 1La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Aragón-Sánchez
authors.forename: Jose L
authors.initials: JL
authors.lastname: Lázaro-Martínez
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001158:Arteries / Q000473:pathology / Q000503:physiopathology; D002114:Calcinosis; D003661:Decision Support Techniques; D017719:Diabetic Foot / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications*; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D013995:Time
keywords: Charcot foot; Monckeberg’s sclerosis; calcification in pedal arteries; diabetic foot; foot ulcer; osteomyelitis