Evidence map›Paper›PMID 30606164›Full record

ArticleBMC endocrine disorders2019

Mortality in patients with diabetic foot ulcer: a retrospective study of 513 cases from a single Centre in the Northern Territory of Australia.

Kanakamani Jeyaraman, Thomas Berhane, Mark Hamilton, Abhilash P Chandra, Henrik Falhammar

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC endocrine disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 5 pooled it
13.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 5 syntheses or guidelines pooled it, 179 citations in OpenAlex.

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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Kanakamani JeyaramanDepartment of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia. Kanakamani.Jeyaraman@nt.gov.au.ORCID http://orcid.org/0000-0002-8220-1302
Thomas BerhaneDepartment of Prosthetics and Orthotics, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Mark HamiltonDepartment of Vascular Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Abhilash P ChandraDepartment of Vascular Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Henrik FalhammarDepartment of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Menzies School of Health Research · AURoyal Darwin Hospital · AUKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetic foot ulcers (DFU) are a common problem in longstanding diabetes. However, mortality outcomes in Australian patients with DFU are still unclear.

methodsAll patients with DFU presenting for the first time to the Multi-Disciplinary Foot Clinic (MDFC) at Royal Darwin Hospital, Northern Territory Australia, between January 2003 and June 2015 were included in this study. These patients were followed until 2017, or death. Individual patient data was extracted from hospital and primary care information systems. Kaplan-Meier survival curves were developed. The association between various risk factors and mortality was analysed using Cox regression.

resultsIn total 666 subjects were screened, and 513 were included in the final analysis. Of these subjects, 247 were Indigenous and 266 were non-Indigenous. The median follow-up period was 5.8 years (IQR, 3.1-9.8). The mean age at inclusion was 59.9 ± 12.3 years and 62.8% were males. The majority (93.6%) had type 2 diabetes and the median diabetes duration was 7 years (IQR, 3-12). There were 199 deaths, with a 5-year-mortality rate of 24.6%, and a 10-year-mortality rate of 45.4%. The mean age at death was 64.6 ± 11.8 years. In a multivariate analysis, the following variables were associated with mortality (adjusted HR, 95% CI): age 1.04 (1.02-1.05, P < 0.001); chronic kidney disease 1.22 (1.11-1.33, P < 0.001), and plasma albumin 0.96 (0.94-0.99, P < 0.05). The most common causes of death were chronic kidney disease (24.6%), cardiovascular events (19.6%), sepsis (15.6%), respiratory failure (10.0%), malignancy (9.5%) and multi-organ failure (5.0%).

conclusionPatients with DFU have high mortality. Age, chronic kidney disease, and low albumin levels increase the risk of mortality. Strategies should focus on ulcer prevention and aggressive risk factor reduction.

Indexed as

AgedAmputation, SurgicalCause of DeathComorbidityDiabetic FootEthnicityFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedNorthern TerritoryRetrospective StudiesRisk FactorsDiabetes complicationsDiabetes mellitusDiabetic foot ulcer

Identifiers

PMID30606164
PMCPMC6318899
OpenAlexW2909122645

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.