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RESEARCH PRODUCT
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
Matthias M. WeberTobias LimbourgChristian FottnerKarin HerrmannKarlheinz BeckhBettina Hartmannsubject
AdultMalemedicine.medical_specialtyTime FactorsArterial diseaseEndocrinology Diabetes and MetabolismObservation periodMedizin030209 endocrinology & metabolismComorbidity030204 cardiovascular system & hematologyAmputation Surgical03 medical and health sciences0302 clinical medicineQuality of lifeRisk FactorsGermanyDiabetes mellitusInternal medicineInternal MedicinemedicineHumansHospital MortalityMobility LimitationAgedRetrospective StudiesAged 80 and overPatient Care TeamWound HealingInterdisciplinary treatmentbusiness.industryEndovascular ProceduresAge FactorsRecovery of FunctionMiddle AgedLimb Salvagemedicine.diseaseDiabetic footDiabetic FootSurgeryTreatment OutcomeQuality of LifeFemaleObservational studyCardiology and Cardiovascular MedicinebusinessVascular Surgical Proceduresdescription
Aims: A major proportion of patients with diabetic foot syndrome are older than 65 years. Little is known about outcomes of these elderly patients. Methods: We analysed 245 treatment cases in an observational single-centre study for comorbidities and outcomes over a 6-month period. Results: 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. Conclusion: 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.
year | journal | country | edition | language |
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2016-10-22 |