Incidence of deep vein thrombosis in patients with diabetic foot ulcers

Gatot, Dairion; Lindarto, Dharma; Mardia, Andri I

doi:10.15562/bmj.v8i2.1048

Cited by 5 publications

(6 citation statements)

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“…Moreover, particularly in cases with a high viral load, the capacity to mount an effective acute immune response against SARS-CoV-2 might be compromised in these patients, thereby rendering them more susceptible to the severe adverse effects associated with COVID-19 [ 24 ]. Moreover, hyperglycemia stimulates the production of coagulation factors such as von Willebrand factor, factor VII, factor VIII, factor IX, factor XII, the extrinsic pathway, and thrombin factor, which leads to excessive thrombus formation in the arteries, veins, and microvascular circulation [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

Oley

Kepel

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Viral infection can compound the severity of pre-existing inflammation caused by underlying diseases. For those with a chronic, immune-related condition such as diabetic foot ulcers (DFUs), the coronavirus disease (COVID-19) serves to exacerbate the inflammatory burden. Serum levels of intracellular adhesion molecule-1 (ICAM-1), a primary mediator of cell adhesion express in the inflammatory process, are often used to indicate the gravity of all inflammatory conditions. Therefore, the purpose of this study was to investigate serum ICAM-1 levels before and after debridement in patients with DFUs who were also diagnosed as COVID-19 positive compared with those who were COVID-19 negative. Methods 20 patients with DFUs were screened for COVID-19 and then divided into COVID-19 positive and negative groups according to the results. Before debridement, chest x-rays and blood analysis, including ICAM-1 serum levels, were performed in both groups. Only ICAM-1 serum levels were measured after debridement. Results Of the 20 patients included in this study, 55% were male (n = 11) and 45% were female (n = 9). The mean age was 52.9 ± 1.9 years. ICAM-1 levels in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group (median 317.2 vs 149.2, respectively; p < 0.001). Serum levels of ICAM-1 reduced significantly in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group after debridement (median 312.5 vs 130.3; p < 0.001). Conclusion ICAM-1 serum levels represent an additional, initial screening marker for COVID-19.

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Section: Discussionmentioning

confidence: 99%

ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

Oley

Kepel

et al. 2021

Annals of Medicine &Amp; Surgery

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“…Patients with DFU have increased mortality rates compared to non-ulcerated diabetic patients 7 . Compounded with VTE, DFU patients may also have delayed ulcer healing rates 4,8 and longer periods of immobility.…”

Section: - Should Patients Undergoing Surgical Debridement Of Diabeti...mentioning

confidence: 99%

“…Rationale: There is increasing evidence that diabetes mellitus (DM) is associated with derangements in coagulation and fibrinolysis leading to a tendency to form thrombi 1,2 . The risk for developing VTE is also elevated in part due to associated co-morbid conditions and frequent hospitalization for acute medical conditions and surgery 3-5 . DM patients who develop VTE are more likely to suffer a complicated clinical course, including long-term major bleeding complications, recurrent VTE 5,6 , major adverse limb events and a higher risk of all-cause mortality 6 .…”

Section: - Should Patients Undergoing Surgical Debridement Of Diabeti...mentioning

confidence: 99%

Recommendations from the ICM-VTE: Foot & Ankle

2022

Journal of Bone and Joint Surgery

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The ICM-VTE Foot & Ankle Delegates* 1 -Should patients undergoing surgical debridement of diabetic foot ulcers receive routine VTE prophylaxis?Response/Recommendation: There is currently no evidence in the literature to determine if a diabetic patient undergoing ulcer debridement requires venous thromboembolism (VTE) prophylaxis. There is, however, an increased risk for morbidity and mortality in diabetic foot ulcers (DFU) patients who develop VTE. Therefore, it is justified to propose that patients with DFU are given thromboprophylaxis, particularly if they have reduced mobility and other medical comorbidities. This may not be true for all cases of surgical debridement alone of DFU without additional interventions when prolonged limited weight-bearing is not required.Strength of Recommendation: Limited.Delegates vote: Agree 100.00% Disagree 0.0% Abstain 0.00% (Unanimous Strong Consensus).Rationale: There is increasing evidence that diabetes mellitus (DM) is associated with derangements in coagulation and fibrinolysis leading to a tendency to form thrombi 1,2 . The risk for developing VTE is also elevated in part due to associated comorbid conditions and frequent hospitalization for acute medical conditions and surgery [3][4][5] . DM patients who develop VTE are more likely to suffer a complicated clinical course, including long-term major bleeding complications, recurrent VTE 5,6 , major adverse limb events and a higher risk of all-cause mortality 6 .Aside from neuropathy, the tendency for thrombosis places DM patients at risk of developing DFU. Patients with DFU have increased mortality rates compared to non-ulcerated diabetic patients 7 . Compounded with VTE, DFU patients may also have delayed ulcer healing rates 4,8 and longer periods of immobility.Despite many reports of elevated risk of VTE in DM patients, no specific recommendations can be found for managing diabetic patients at risk for VTE. For this review, a search in PubMed revealed 244 papers but none specifically discuss VTE prophylaxis for DFU patients undergoing surgery, nor for DM patients in general.In a review of 2,488 patients with validated VTE in the Worcester Venous Thromboembolism Study, Piazza et al., reported a low rate of thromboprophylaxis among the 476 patients with VTE and DM 5 . Wang et al., highlighted the impact of a history of VTE on major adverse limb events (MALEs) and concluded that prevention of thrombotic events needed to be emphasized in patients requiring diabetic foot care 6 . Aside from increased all-cause mortality rates, they showed that a history of VTE was associated with a 1.6-fold increased risk of MALEs and a 1.4-fold higher risk of major amputation.

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“…Nearly 80% of patients with T2DM die due to complications associated with the disease. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis 2‐4 . T2DM patients have an aggregate thrombotic risk including hyperreactivity of platelets, upregulation of prothrombotic markers, and a decrease in fibrinolysis.…”

Section: Introductionmentioning

confidence: 99%

Quality of glycemic control in type 2 diabetes mellitus (T2DM) and its association with markers of coagulation and inhibitors of fibrinolysis: A case–control study in the Upper West Region, Ghana

Selleh,

Anto,

Boadu

et al. 2023

Health Science Reports

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Background and Aims: Type 2 diabetes mellitus (T2DM) individuals are at a higher risk of developing diabetes complications, with approximately 80% complicationrelated mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis.Methods: This case-control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), prothrombin time (PT), calculated international normalized ratio (INR), and full blood count (FBC) were determined for each respondent. Plasma levels of plasminogen activator inhibitor-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) were determined using the solid-phase sandwich enzyme-linked immunosorbent assay method. Data were analyzed using R language software.Results: Plasma PAI-1 antigen levels were significantly higher in the participants with poor glycemic control as compared to participants with good glycemic control (p < 0.0001). There was no significant difference in plasma TAFI levels between the participants with poor glycemic control as compared to participants with good glycemic control (p = 0.900). T2DM patients had significantly shorter APTT, PT, and INR than controls (p < 0.05). At a cut-off of ≥161.70 pg/μL, PAI was independently

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Incidence of deep vein thrombosis in patients with diabetic foot ulcers

Cited by 5 publications

References 0 publications

ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

Recommendations from the ICM-VTE: Foot & Ankle

Quality of glycemic control in type 2 diabetes mellitus (T2DM) and its association with markers of coagulation and inhibitors of fibrinolysis: A case–control study in the Upper West Region, Ghana

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