Luca Monge1, Roberto Gnavi2, Paolo Carnà3, Fabio Broglio4, Gian Mario Boffano5, Carlo Bruno Giorda6. 1. Diabetic Foot Center, AOU Città della Salute e della Scienza di Torino, Turin, Italy. amd-to.monge@alma.it. 2. Epidemiology Unit, ASL TO3, Grugliasco, TO, Italy. roberto.gnavi@epi.piemonte.it. 3. Epidemiology Unit, ASL TO3, Grugliasco, TO, Italy. 4. Department of Medical Science, University of Turin, Turin, Italy. 5. Diabetic Foot Center, AOU Città della Salute e della Scienza di Torino, Turin, Italy. 6. Diabetes Unit, ASL TO5, Chieri, TO, Italy.
Abstract
AIMS: The aim of our study was to estimate the overall rate of first hospitalizations for diabetic foot (DF) regardless of the outcome in amputations, as well as the mortality rate with their determinants in the period 2012-2016 in Piedmont Region in Italy. METHODS: The study included all the subjects registered in the Regional Diabetes Registry and alive as at January 1, 2012. DF cases were identified by record linkage with the regional hospital discharge database. Incident cases of diabetic foot were followed up for mortality. RESULTS: The 5-year rates were 1762, 324, and 343 × 100,000 patients for first hospitalization without amputations, with major amputations, and with minor amputations, respectively. Patients not undergoing amputations were more than 70% of the cohort. Patients with the more severe stages of diabetes and those with low education were at higher risk of each type of hospitalization. The risk of death during a mean follow-up of 2.5 years was about 16, 18, and 30% among patients without amputations, with major amputations, and with minor amputations, respectively. Males, insulin-treated patients, those affected with severe diabetes complications, particularly on dialysis, and those with lower levels of education were at higher risk. CONCLUSIONS: The heavier burden of DF on hospitalizations is due to cases without amputation, a condition that is seldom considered in the diabetes literature. The severity of diabetes, preexisting complications, and low educational levels are associated with both first hospitalization and subsequent survival at any level of severity of DF.
AIMS: The aim of our study was to estimate the overall rate of first hospitalizations for diabetic foot (DF) regardless of the outcome in amputations, as well as the mortality rate with their determinants in the period 2012-2016 in Piedmont Region in Italy. METHODS: The study included all the subjects registered in the Regional Diabetes Registry and alive as at January 1, 2012. DF cases were identified by record linkage with the regional hospital discharge database. Incident cases of diabetic foot were followed up for mortality. RESULTS: The 5-year rates were 1762, 324, and 343 × 100,000 patients for first hospitalization without amputations, with major amputations, and with minor amputations, respectively. Patients not undergoing amputations were more than 70% of the cohort. Patients with the more severe stages of diabetes and those with low education were at higher risk of each type of hospitalization. The risk of death during a mean follow-up of 2.5 years was about 16, 18, and 30% among patients without amputations, with major amputations, and with minor amputations, respectively. Males, insulin-treated patients, those affected with severe diabetes complications, particularly on dialysis, and those with lower levels of education were at higher risk. CONCLUSIONS: The heavier burden of DF on hospitalizations is due to cases without amputation, a condition that is seldom considered in the diabetes literature. The severity of diabetes, preexisting complications, and low educational levels are associated with both first hospitalization and subsequent survival at any level of severity of DF.
Authors: Silvia Cascini; Nera Agabiti; Marina Davoli; Luigi Uccioli; Marco Meloni; Laura Giurato; Claudia Marino; Anna Maria Bargagli Journal: BMJ Open Diabetes Res Care Date: 2020-07
Authors: Enrico Torre; Giorgio Lorenzo Colombo; Sergio Di Matteo; Chiara Martinotti; Maria Chiara Valentino; Alberto Rebora; Francesca Cecoli; Eleonora Monti; Marco Galimberti; Paolo Di Bartolo; Germano Gaggioli; Giacomo Matteo Bruno Journal: Clinicoecon Outcomes Res Date: 2021-06-14