Clinical characteristics of foot ulceration in people with chronic gout

Rome, Keith; Erikson, Kathryn; Otene, Cynthia; Sahid, Hazra; Sangster, Karyn; Gow, Peter

doi:10.1111/iwj.12262

Cited by 15 publications

(11 citation statements)

References 34 publications

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“…This finding is not dissimilar to baseline scores reported in other research . Our sample reported higher scores for all sub‐scales of the CWIS than people who have gout‐related foot wounds and slightly higher physical symptom and daily living scores than people with lower leg ulcers . Our sample reported similar baseline CWIS sub‐scales and overall scores for participants of a compression therapy RCT , a cell‐grafting evaluation and a pilonidal sinus disease study .…”

Section: Discussionsupporting

confidence: 74%

“…Several studies using the CWIS have investigated quality of life at one time point or over time. Moderate to good quality of life among older men with gout‐related foot wounds has been reported for the social life score (mean 61·0, SD 24·3), well‐being score (mean 73·3, SD 15·4) and physical symptoms and daily living score (mean 66·7, SD 28·5) . A study investigating the quality of life of leg, foot and pressure injury patients receiving negative pressure wound therapy found that people receiving the intervention had improved social life scores during the first 2 weeks when compared to controls; however, there were no other significant differences for other sub‐scales of the CWIS at a range of time points up to 12 weeks .…”

Section: Literature Reviewmentioning

confidence: 99%

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The financial and quality‐of‐life cost to patients living with a chronic wound in the community

Kapp

Santamaria

2017

International Wound Journal

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Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds. A questionnaire incorporating the Cardiff Wound Impact Schedule and purpose-designed instruments was completed by a non-probability, convenience sample of 113 people in Australia and Wales. Data was analysed using descriptive statistics. The sample was on average 63·6 years of age and had wounds that were on an average 109 weeks duration. Participants had spent on average AU$2475 on wound dressing products since the wound started, and AU$121·82 in the most recent 28 days which represented 10% of their disposable income. Health-related quality of life was sub-optimal, 6/10 (ave) according to the Cardiff Wound Impact Schedule. Younger participants reported significantly poorer quality of life on all CWIS sub-scales when compared to older participants. This study found that chronic wounds present a significant financial cost to individuals who must self-fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub-optimal quality of life therefore this condition is also costly to the individual's well-being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurrent condition. Continued action is required to reduce the financial and personal costs experienced by people who have chronic wounds. It is imperative that healthcare funding is directed to people who have chronic wounds, in particular to alleviate the out-of-pocket costs experienced by self-funders. Continued attention to the quality of life of people who have chronic wounds is required to minimise the negative effects of this condition and enhance well-being.

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Section: Discussionsupporting

confidence: 74%

Section: Literature Reviewmentioning

confidence: 99%

The financial and quality‐of‐life cost to patients living with a chronic wound in the community

Kapp

Santamaria

2017

International Wound Journal

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“…In addition, most patients presented ulceration in 1 area, whereas several patients suffered from multiple ulcerations. The present study also found that ulceration over tophi was most commonly seen in feet (MTP and ankle), which was in line with previous studies, which may be attributed to the biomechanical loading or physical stress during the normal gait cycle …”

Section: Discussionsupporting

confidence: 93%

Clinical characteristics and risk factors of ulceration over tophi in patients with gout

Huang

Liu

et al. 2019

Int J of Rheum Dis

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Objectives To describe clinical characteristics of ulceration over tophi in patients with gout and determine risk factors associated with ulceration. Methods Patients presenting with tophi or ulceration(s) over tophi were prospectively recruited and their clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for ulceration were analyzed between groups. Results A total of 105 patients were enrolled. Thirty‐three patients with ulcerations were older, with prolonged duration with gout and tophi, a higher rate of obesity, greater numbers of tophi, lower levels of glomerular filtration rate (GFR), and higher levels of serum creatinine, erythrocyte sedimentation rate and C‐reactive protein. The mean duration of ulceration was 1.63 ± 2.32 months. The ulcerations were mainly located in the ankle (34.21%) and metatarsophalangeal joints (39.47%), with a mean size of 32.37 × 22.76 mm. The majority of ulcerations were categorized as stage I (42.4%) and stage II (51.5%). In univariate regression analysis, age, glucocorticoid overuse, gout duration, tophi duration, tophi number and GFR were associated with ulceration. In the multivariable model, significant differences were demonstrated in glucocorticoid overuse, tophi duration, tophi number. Conclusions Gout patients with ulceration(s) over tophi present several different aspects of clinical characteristics compared with those without ulceration. The ulcerations are most commonly seen in feet and they are mainly categorized as stages I and II. Glucocorticoid overuse, prolonged duration with tophi and greater numbers of tophi are risk factors for ulceration over tophi.

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“…Although those comorbidities were not included in the regression model, they all have a potential effect on the formation of ulceration. Rome et al reported a study of the clinical characteristics of foot ulceration in people with chronic gout , which showed that those affected were predominantly older men with a long duration of gout and that most wore shoes that were considered poor footwear. The present study also found that lack of protective sensation was independently associated with ulceration over tophi, suggesting that careful monitoring of people with gouty ulceration is warranted.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for ulceration over tophi in patients with gout

Cai

Zhang

et al. 2016

International Wound Journal

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Ulceration over tophi in patients with gout usually causes a number of clinical problems. The aim of this study was to investigate the risk factors for ulceration of tophi in patients with gout. Patients with gout who had tophi with or without ulceration were prospectively recruited and underwent a comprehensive clinical assessment. Clinical factors independently associated with the presence of ulceration were analysed using logistic regression models. Of the 113 participants, 18 (13·7%) had clinically apparent ulceration over tophi. In univariate analysis, ulceration over tophi correlated with age, tophus duration, size, location and lack of protective sensation. In logistic regression analysis, age, tophus size and lack of protective sensation were associated with ulceration over tophi. These findings indicate that old age, large tophus size and lack of protective sensation were independent risk factors for ulceration over tophi.

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Clinical characteristics of foot ulceration in people with chronic gout

Cited by 15 publications

References 34 publications

The financial and quality‐of‐life cost to patients living with a chronic wound in the community

The financial and quality‐of‐life cost to patients living with a chronic wound in the community

Clinical characteristics and risk factors of ulceration over tophi in patients with gout

Risk factors for ulceration over tophi in patients with gout

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