In-hospital mortality and length of stay in patients with diabetes having foot disease

Nirantharakumar, Krishnarajah; Saeed, Mujahid; Wilson, Ian C.; Marshall, Tom; Coleman, Jamie J.

doi:10.1016/j.jdiacomp.2013.05.003

Cited by 33 publications

(27 citation statements)

References 18 publications

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“…The findings of this review reinforce the conclusions from earlier work by Brownrigg et al . which showed that individuals with diabetic foot ulcers have a significantly higher risk of all‐cause mortality compared with those with diabetes but without foot ulceration , with a tendency towards increased risk of fatal myocardial infarction and a trend towards higher stroke incidence. Our search found three further studies, none of which provided data on cause‐specific cardiovascular disease‐related deaths .…”

Section: Discussionmentioning

confidence: 99%

Foot ulceration and its association with mortality in diabetes mellitus: a meta‐analysis

et al. 2019

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Background Diabetic foot ulcers portend an almost twofold increase in all-cause mortality compared with diabetes on its own. Aim To investigate the association between diabetic foot ulcers and risk of death. Methods We performed a meta-analysis of all observational studies investigating the association between diabetic foot ulcers and all-cause mortality. Risk ratios and risk differences were pooled in a random-effects model. The I 2 statistic was used to quantify heterogeneity between studies.Results Altogether, we identified 11 studies that reported 84 131 deaths from any cause in 446 916 participants with diabetes during a total of 643 499 person-years of follow-up. The crude event rate for all-cause mortality in individuals with diabetes who did not develop foot ulceration was 22% lower at 181.5 deaths (per 1000 person-years) than in those who developed foot ulcers (230.8 per 1000 person-years). Diabetic foot ulceration was associated with an increased risk of all-cause mortality (pooled relative risk 2.45, 95% CI 1.85-2.85). We did not observe any tangible differences in risk of all-cause mortality from diagnosis in studies reporting a mean duration of follow-up of ≤3 years (relative risk 2.43, 95% CI 2.27-2.61) or >3 years (relative risk 2.26, 95% CI 2.13-2.40) years. Funnel plot inspection revealed no significant publication bias among studies included in this meta-analysis. ConclusionsOur study shows an excess rate of all-cause mortality in people with diabetic foot ulceration when compared to those without foot ulceration. It is imperative that early interventions to prevent foot ulceration and modify cardiovascular disease risk factors are put in place to reduce excess mortality.

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Section: Discussionmentioning

confidence: 99%

Foot ulceration and its association with mortality in diabetes mellitus: a meta‐analysis

et al. 2019

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“…Diabetic foot not only extends the hospital stay but also increases the in-hospital mortality [14]. Interveners need to concentrate their activities on change patients' attitudes and minds instead of just providing them with the instructions on foot care.…”

Section: 3mentioning

confidence: 99%

The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China

et al. 2014

International Journal of Nursing Sciences

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KnowledgeSelf-care a b s t r a c t Purpose: To investigate the knowledge and behaviours on foot self-care in patients with type 2 diabetes mellitus; analyse the influential factors, and provide information for the intervention study.Methods: A total of 5961 patients with type 2 diabetes mellitus from 144 hospitals in China were included in the study. The investigation content included patients' demographic data, foot self-care knowledge and behaviours. The investigation tools were the questionnaires on the general diabetes information, on the foot self-care knowledge, and on the foot selfcare behaviours.Results: The foot self-care knowledge was medium and the foot self-care behaviour was poor. The status of knowledge and behaviours were influenced by education, duration of diabetes mellitus, periodic inspection, and education about diabetic complications. Pearson analysis demonstrated that there was positive correlation between knowledge score and behaviour score (r ¼ 0.27, p < 0.001).Conclusions: The status of foot self-care knowledge and behaviours are not optimistic. According to the patients' own characteristics, the theory of knowledge, attitude and practice applies to encouraging patients to go for periodic inspection and education about diabetic complications so as to enhance the knowledge and promote the self-care behaviours.

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“…Insulin therapy was defined as one or more prescription for insulin during the admission; these data were not available for Ipswich, therefore, insulin prescription prior to admission was used. Presence of foot disease was identified using both discharge diagnostic codes and OPCS Classification of Interventions and Procedures codes recorded at any time during the admission [13]. In instances where a patient had multiple blood tests during a single admission, the earliest test result for the admission was used.…”

Section: What's New?mentioning

confidence: 99%

“…Hospitalized patients with diabetes have high infection rates [2][3][4][5], longer length of stay (1-3 more days compared with patients without diabetes) [6][7][8] and a higher mortality rate (6.4% higher) [9]. The reasons for poor clinical outcomes are less well understood but poor glycaemic control and foot disease have been implicated as potential reasons [10][11][12][13]. In 2009/2010, people with diabetes accounted for 11% of National Health Service (NHS) expenditure on in-hospital care, totalling approximately £2.5 bn [14].…”

Section: Introductionmentioning

confidence: 99%

Temporal and external validation of a prediction model for adverse outcomes among inpatients with diabetes

et al. 2018

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In-hospital mortality and length of stay in patients with diabetes having foot disease

Cited by 33 publications

References 18 publications

Foot ulceration and its association with mortality in diabetes mellitus: a meta‐analysis

Foot ulceration and its association with mortality in diabetes mellitus: a meta‐analysis

The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China

Temporal and external validation of a prediction model for adverse outcomes among inpatients with diabetes

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