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Infectious diseases, vaccines and treatments

Session: Poster Session A

(283) Recurrence of Diabetic Foot Complications: A Domino Effect Leading to Lethal Consequences - Insights from a National Longitudinal Study

Monday, August 26, 2024

8:00 AM – 6:00 PM CEST

Location: Convention Hall II

Co-Author(s)

CH

Chun-Chien Hsu

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan (Republic of China)

Presenting Author(s)

HL

Hsi-Yu Lai, MS

Research associate
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan (Republic of China)

Co-Author(s)

HL

Hung-Yu Lin

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan (Republic of China)
SP

Sung-Ching Pan

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Center for Infection Control, National Taiwan University Hospital, Taiwan., Taiwan (Republic of China)
NC

Nai-Chen Cheng

Department of Surgery, National Taiwan University Hospital and College of Medicine, 7 Chung-Shan S. Rd., Taipei, 100, Taiwan, Taiwan (Republic of China)
LC

Liang-Kung Chen, MD,PhD

Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taiwan (Republic of China)
SL

Shu-Wen Lin

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan (Republic of China)
FH

Fei-Yuan Hsiao, PhD

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan (Republic of China)

Background: Foot complications are common in people with diabetes mellitus (DM), leading to increased healthcare utilization, heightened mortality risk, and notable recurrence rates even after treatment.

Objectives: This retrospective cohort study aimed to investigate the impact of repeated occurrence of DM-related foot complications on the risk of all-cause mortality and to identify the potential risk factors associated with repeated events.

Methods: People with DM admitted with foot complications (ulcer, skin and soft tissue infection or osteomyelitis) from 2012 to 2014 were identified from Taiwan’s National Health Insurance Research Database, with a three-year follow-up for repeated events. We categorized the study subjects based on their cumulative number of hospital admission with foot complications. Logistic regression was conducted to explore the potential risk factors associated with repeated diabetic foot events. Kaplan-Meier curves and Cox proportional hazard models were used to examine the associations between repeated diabetic foot events and all-cause mortality.

Results: A total of 28,754 eligible individuals were enrolled and classified into three groups: no repeated diabetic foot events (76.1%), one repeated event (16.0%), and two or more repeated events (7.9%). Multivariable logistic regression revealed that advanced age, males, and those with congestive heart failure, dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, peripheral vascular disease, diabetes-related preventable hospitalizations, and outpatient visits due to diabetic foot were significantly associated with repeated events of diabetic foot complications. Compared to those with no repeated events, the adjusted hazard ratio (95% CI) for all-cause mortality were 1.26 (1.19-1.34) for one repeated event group and 1.36 (1.26-1.47) for two or more repeated events group.

Conclusions: The significant association between recurrent diabetic foot events and increased mortality risk underscores the vital importance of proactive and focused patient management in clinical settings. Further research is essential to identify predictive factors for repeated diabetic foot occurrences to provide insights for the development of effective prevention strategies.