Outcomes of Diabetic Foot Ulcers in a Tertiary Referral Interdisciplinary Clinic: A Retrospective Canadian Study

Fournier, Cynthia; Singbo, Narcisse; Morissette, Nadesh; Thibeault, Marie-Marthe

doi:10.1016/j.jcjd.2020.09.004

Cited by 14 publications

(17 citation statements)

References 16 publications

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“…The result of assessment of risk of bias is presented in Table S2. Twenty‐three studies 9‐31 had a low risk of bias, and five studies 32‐36 had a moderate risk of bias. Six studies were identified as having a serious risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Aggregate data-based survival was pooled from all available studies, including Kaplan-Meier-based survival data estimated from the aforementioned 27 studies and data extracted from the articles that only reported annual mortality. 11,22,26,28,32,39 Six studies only reported 1-year survival. 11,22,26,28,32,39 Of these, one study reported 3-year survival 32 and two studies reported 5-year survival.…”

Section: Mortalitymentioning

confidence: 99%

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Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies

Sun

Gao

Ran

2022

Diabetes Obesity Metabolism

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Section: Resultsmentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies

Sun

Gao

Ran

2022

Diabetes Obesity Metabolism

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“…The results showed that there is no statistically significant association between TC and the recurrence of DFU (OR = 1.33, 95%CI, 0.57-3.11, P = 0.52) (Figure 12). Three studies 9,23,25 mentioned the effect of toe or extremity amputation on the recurrence of DFU. Moderate heterogeneity was found among the three included studies (Ι 2 = 68%, P = 0.04).…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…(Figure 18). Two studies 24,25 mentioned the effect of history of ulcer on the recurrence of DFU. The heterogeneity of the two included studies was small (Ι 2 = 42%, P = 0.19).…”

Section: Results Of Meta-analysismentioning

confidence: 99%

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Influencing factors for the recurrence of diabetic foot ulcers: A meta‐analysis

Guo

Ouyang

et al. 2022

International Wound Journal

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This study aims to systematically review and identify the related influencing factors for the recurrence of diabetic foot ulcers (DFUs)in diabetic patients. We searched PUBMED, EMBASE, Web of Science, Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang and VIP databases to identify eligible studies published before March 31, 2022 to collect case-control studies or cohort studies on the related influencing factors for the recurrence of DFUs. Two reviewers independently screened the literature, and extracted data. Also, they assessed the risk of bias of the included studies using the Newcastle-Ottawa Scale. A meta-analysis was performed using RevMan5.4.1 software. 20 studies were included; 4238 patients were enrolled, in which 1567 were in the DFU recurrence group and 2671 were in the non-recurrent DFU group. Risk factors for the recurrence of DFUs included diabetic peripheral neuropathy (odds ratio [OR] = 4.05, 95% CI, 2.50-6.58, P < 0.00001), peripheral vascular disease (OR = 3.94, 95% CI, 2.65-5.84, P < 0.00001), poor blood glucose control (OR = 3.27, 95% confidence interval [CI], 2.79-3.84, P < 0.00001), plantar ulcer (OR = 3.66, 95% CI, 2.06-6.50, P < 0.00001), osteomyelitis (OR = 7.17, 95% CI, 2.29-22.47, P = 0.0007), smoking (OR = 1.98, 95% CI, 1.65-2.38, P < 0.00001), history of amputation (OR = 11.96, 95%CI, 4.60-31.14, P < 00001), multidrug-resistant bacterial infection (OR = 3.61, 95%CI, 3.13-4.17, P < 0.00001), callus (OR = 5.70, 95%CI, 1.36-23.89, P = 0.02), previous diabetic foot ulcer (OR = 4.10, 95% CI, 2.58-6.50, P < 0.00001), duration of previous diabetic foot ulcer >60d (OR = 1.02, 95% CI, 1.00-1.03, P = 0.004), history of vascular intervention (OR = 3.20, 95% CI, 2.13-4.81, P < 0.00001) and Wagner grade III/IV (OR = 4.40, 95% CI, 2.21-8.78, P < 0.0001). However, no significant differences were found in age, duration of diabetes, body mass index, total cholesterol or foot deformity. Recurrence of diabetic foot ulcers is affected by a variety of factors. Thus, we should focus on high-risk groups and take targeted interventions as soon as possible to reduce the recurrence rate of DFUs, because of the

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Development and validation of a risk prediction model for the recurrence of foot ulcer in type 2 diabetes in China: A longitudinal cohort study based on a systematic review and meta‐analysis

Wang

Chen

et al. 2023

Diabetes Metabolism Res

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Aims To develop and validate a risk prediction model for Chinese patients with type 2 diabetes with the recurrence of diabetic foot ulcers (DFUs) based on a systematic review and meta‐analysis. Methods A prospective analysis was performed with 1333 participants and followed up for 60 months. Three models were analysed using a derived cohort. The risk factors were screened using meta‐analysis and logistic regression, and the missing variables were interpolated by multiple imputation. The internal validation was performed using the bootstrap procedure, and the validation cohort was applied to the external validation. The performance of the model was evaluated in the area under the discrimination Receiver Operating Characteristic Curve (ROC). Calibration and discrimination methods were used for the validation cohort. The variables were selected according to their clinical and statistical importance to construct the nomograms. Results Three models were developed and validated. Model 1 included seven social and clinical indicators like sex, diabetes mellitus duration, previous DFU, location of ulcer, smoking, history of amputation, and foot deformity. Model 2 included four more indicators besides those in Model 1, which were statin agents used, antiplatelet agents used, systolic blood pressure, and body mass index. Model 3 added further laboratory indicators to Model 2, such as LDL‐C, HbA1C, fibrinogen, and blood urea nitrogen. In the derivation cohort, 20.1% (206/1027) participants with DFU recurred as compared to the validation cohort, which was 38.2% (117/306). The areas under the curve in the derivation cohort for Models 1–3 were 0.781 (0.744–0.817), 0.843 (0.813–0.873), and 0.899 (0.876–0.922), respectively. The Youden indexes for Models 1–3 were 0.430, 0.559, and 0.653, respectively. Model 3 showed the highest sensitivity and specificity. All models performed well for both discrimination and calibration. Conclusions Models 1–2 were non‐invasive, which indicate their role in general screening for patients at a high risk of recurrence of DFU. However, Model 3 offers a more specific screening due to its best performance in predicting the risk of DFU recurrence amongst the three models.

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Outcomes of Diabetic Foot Ulcers in a Tertiary Referral Interdisciplinary Clinic: A Retrospective Canadian Study

Cited by 14 publications

References 16 publications

Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies

Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies

Influencing factors for the recurrence of diabetic foot ulcers: A meta‐analysis

Development and validation of a risk prediction model for the recurrence of foot ulcer in type 2 diabetes in China: A longitudinal cohort study based on a systematic review and meta‐analysis

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