title: Interdisciplinary treatment of diabetic foot wounds in the elderly: Low risk of amputations and mortality and good chance of being mobile with good quality of life.
abstract: A major proportion of patients with diabetic foot syndrome are older than 65 years. Little is known about outcomes of these elderly patients.
  
  
  
  We analysed 245 treatment cases in an observational single-centre study for comorbidities and outcomes over a 6-month period.
  
  
  
  In all, 122 patients had peripheral arterial disease which was significantly increasing with age (n = 245, df = 1, χ2= 23.06, p ⩽ 0.0001). Increasing age correlated positively with decreasing rate of revascularisations (n = 122, df = 1, χ2= 4.23, p = 0.039). In total, 23 (9.3%) patients died in the observation period. In-hospital mortality was 2.8%, percentage of major amputations 2.8%. In the invasively treated subgroup, 13 out of 67 patients died within the observation period. Death after revascularisation was independent of age (n = 67, df = 1, χ2= 2.05, p = 0.153). Mobility decreased in the whole study group with increasing age. The risk of decrease with age was not influenced by revascularisation status.
  
  
  
  With careful interdisciplinary evaluation, elderly patients with diabetic foot syndrome can be treated with favourable outcome. Mobility before and after treatment deserves more attention as a predictor of treatment success and outcome parameter.
authors.affiliation: Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Ludwigshafen, Germany hartmanb@klilu.de.
authors.forename: Bettina
authors.initials: B
authors.lastname: Hartmann
authors.affiliation: I. Medical Clinic, Department of Endocrinology and Metabolism, University of Mainz, Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Fottner
authors.affiliation: Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Stiftung IHF, Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Limbourg
authors.affiliation: I. Medical Clinic, Department of Endocrinology and Metabolism, University of Mainz, Mainz, Germany.
authors.forename: Matthias M
authors.initials: MM
authors.lastname: Weber
authors.affiliation: Department of Gastroenterology and Diabetology, Klinikum Worms, Worms, Germany.
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Beckh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D017719:Diabetic Foot / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010348:Patient Care Team; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D014945:Wound Healing
keywords: Diabetic foot syndrome; elderly patients; mobility; quality of life; revascularisation