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Diabetic foot complications—lessons learned from real-world data derived from a specialized Austrian hospital

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Summary

Background

Diabetic foot complications, one of the most severe late complications of type 2 diabetes mellitus, are associated with a tremendous personal and financial burden. In order to drive the prevention of diabetic foot complications forward and facilitate early detection and personalized screening of high-risk patients, longitudinal studies are needed to identify risk factors associated with diabetic foot complications in large patient datasets.

Methods

This is a retrospective cohort study on 3002 patients with type 2 diabetes mellitus aged ≥ 18 years without prior foot complications. The data were collected between 2006 and 2017 in an Austrian hospital department specialized for diabetic patients. In addition to a univariate Cox regression analysis, multivariate Cox regression models were established to identify independent risk factors associated with diabetic foot complications and adjust for potential confounders.

Results

We observed a total of 61 diabetic foot complications in 3002 patients. In the multivariate Cox regression model, significant risk factors (hazard ratio, 95% confidence interval) for foot complications were age at diagnosis > 70 years (3.39, 1.33–8.67), male gender (2.55, 1.42–4.55), neuropathy (3.03, 1.74–5.27), peripheral arterial disease (3.04, 1.61–5.74), hypertension > 10 years after diagnosis (2.32, 1.09–4.93) and HbA1c > 9% (2.44, 1.02–5.83).

Conclusion

The identified risk factors for diabetic foot complications suggest that personalized early detection of patients at high risk might be possible by taking the patient’s clinical characteristics, medical history and comorbidities into account. Modifiable risk factors, such as hypertension and high levels of blood glucose might be tackled to reduce the risk for diabetic foot complications.

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Author information

Authors and Affiliations

  1. Research Unit for Diabetes Epidemiology, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT—Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria

    Sophia Rossboth, Hans Schoenherr & Willi Oberaigner

  2. Department of Internal Medicine, St. Vinzenz Hospital Zams, Zams, Austria

    Hans Schoenherr & Christian Ciardi

  3. Department of Internal Medicine, Hospital Hochzirl, Zirl, Austria

    Monika Lechleitner

Authors
  1. Sophia Rossboth
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  2. Benedikt Rossboth
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  4. Christian Ciardi
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  5. Monika Lechleitner
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  6. Willi Oberaigner
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Contributions

S. Rossboth developed the protocol, conducted the analysis and wrote the manuscript. B. Rossboth assisted in the statistical analysis and the design of the tables and figures. W. Oberaigner was involved in the study design, the conduction of the analysis and writing the article. H. Schoenherr, C. Ciardi and M. Lechleitner contributed their clinical expertise to writing the introduction, results and discussion section. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Sophia Rossboth.

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Conflict of interest

S. Rossboth, B. Rossboth, H. Schoenherr, C. Ciardi, M. Lechleitner and W. Oberaigner declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The Ethics Committee of the Medical University of Innsbruck approved the present study as part of the Diabetes Registry Tyrol. Due to the retrospective characteristics of the study, no ethics committee approval is required by Austrian law. This information was confirmed by the Ethics Committee of the Medical University of Innsbruck in a general statement. Procedures involving patients, patient data collection, and handling and storage of personal data are in accordance with national laws and the ethical standards of the seventh revision of the Declaration of Helsinki. In addition, the study was approved by the Research Committee for Scientific Ethical Questions at UMIT University. Informed consent was obtained from all individual participants included in the study.

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Rossboth, S., Rossboth, B., Schoenherr, H. et al. Diabetic foot complications—lessons learned from real-world data derived from a specialized Austrian hospital. Wien Klin Wochenschr 134, 7–17 (2022). https://doi.org/10.1007/s00508-021-01864-5

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