Willem D Rinkel1, Shelly van Nieuwkasteele2, Manuel Castro Cabezas3, Johan W van Neck4, Erwin Birnie5, J Henk Coert6. 1. Department of Plastic-, Reconstructive- and Hand Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands; Department of Plastic-, Reconstructive- and Hand Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands. Electronic address: w.d.rinkel@umcutrecht.nl. 2. Department of Plastic-, Reconstructive- and Hand Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands; Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. 3. Department of Internal Medicine/Centre for Diabetes, Endocrinology and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands. 4. Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. 5. Department of Statistics and Education, Franciscus Academy, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands; Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 6. Department of Plastic-, Reconstructive- and Hand Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands; Department of Plastic-, Reconstructive- and Hand Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
Abstract
AIMS: Sensory loss and impaired balance are considered risk factors of incident falls. The aim of this study was to assess the relationship between degree of foot sensation and balance, risk of falls, incidence of fall-related injuries and costs in a cohort of patients with diabetes. METHODS: (Non)-neuropathic subjects participating in the Rotterdam Diabetic Foot Study were followed prospectively. Subjects underwent sensory testing of the feet (39 item Rotterdam Diabetic Foot Study Test Battery (RDF-39)); balance was assessed at the second follow-up (Brief-BESTest) as were data on incident falls. Medical records and financial data were abstracted to estimate fall-related morbidity and in-hospital costs. RESULTS: A higher RDF-39 score, cerebral artery disease, type 2 diabetes, height and age were predictors of the Brief-BESTest total score. 41/296 patients (13.9%) reported two or more falls during follow-up. Predictors for recurrent falls were a higher RDF-39 score (aOR: 1.124, p < 0.0005), male gender (aOR: 0.319, p = 0.016), age (aOR: 0.938, p = 0.003) and type 2 diabetes (aOR: 3.157, p = 0.100). Thirty-one patients used medical resources (median US$ 440.45 (IQR: 179-1162). CONCLUSIONS: Degree of sensory loss correlates significantly with an increased imbalance and risk of falls. The RDF-39 may be used as stratification tool in medical decision-making and patient information.
AIMS: Sensory loss and impaired balance are considered risk factors of incident falls. The aim of this study was to assess the relationship between degree of foot sensation and balance, risk of falls, incidence of fall-related injuries and costs in a cohort of patients with diabetes. METHODS: (Non)-neuropathic subjects participating in the Rotterdam Diabetic Foot Study were followed prospectively. Subjects underwent sensory testing of the feet (39 item Rotterdam Diabetic Foot Study Test Battery (RDF-39)); balance was assessed at the second follow-up (Brief-BESTest) as were data on incident falls. Medical records and financial data were abstracted to estimate fall-related morbidity and in-hospital costs. RESULTS: A higher RDF-39 score, cerebral artery disease, type 2 diabetes, height and age were predictors of the Brief-BESTest total score. 41/296 patients (13.9%) reported two or more falls during follow-up. Predictors for recurrent falls were a higher RDF-39 score (aOR: 1.124, p < 0.0005), male gender (aOR: 0.319, p = 0.016), age (aOR: 0.938, p = 0.003) and type 2 diabetes (aOR: 3.157, p = 0.100). Thirty-one patients used medical resources (median US$ 440.45 (IQR: 179-1162). CONCLUSIONS: Degree of sensory loss correlates significantly with an increased imbalance and risk of falls. The RDF-39 may be used as stratification tool in medical decision-making and patient information.
Authors: Artur Stolarczyk; Igor Jarzemski; Bartosz M Maciąg; Kuba Radzimowski; Maciej Świercz; Magda Stolarczyk Journal: BMC Endocr Disord Date: 2021-07-03 Impact factor: 2.763