NEW YORK (Reuters Health) - Although the majority of patients hospitalized because of diabetic foot ulcers initially do reasonably well, in the long-term the outcome is often poor, French researchers report in the journal Diabetes Care.
"Despite a satisfactory rate of healing," investigator Dr. Antoine Avignon told Reuters Health, "the overall prognosis of patients with diabetic foot ulcers is not satisfactory."
Avignon of Universite Montpellier 1 and colleagues came to this conclusion after following 89 patients with diabetic foot ulcers for an average of more than 6 years.
Altogether, the ulcer healed in 69 patients, who were able to avoid major amputation. However, 42 of the 69 patients had a recurrence of the ulcer, and by the end of the follow-up period, 25 patients (28.1 percent) were disabled and dependent on care.
In total, only 40 of the original 89 patients studied (44.9 percent) achieved complete therapeutic success according to the criteria employed.
Over the course of the study, 46 patients died; 23 patients died of cardiovascular causes, but 9 died from a complication of the foot ulcer. After accounting for factors that could influence the outcome, such as age, only kidney impairment was an independent predictor of mortality.
"In our opinion," concluded Antoine, "it is essential to define internationally recognized success criteria for the care of diabetic foot ulcers. Those criteria must go beyond just the evaluation of healing rates."
SOURCE: Diabetes Care, July 2008.
