ArticleEndocrinology, diabetes & metabolism2022
The association of chronic, enhanced immunosuppression with outcomes of diabetic foot infections.
Article in Endocrinology, diabetes & metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- From Control to Cure: Insights into the Synergy of Glycemic and Antibiotic Management in Modulating the Severity and Outcomes of Diabetic Foot Ulcers.International journal of molecular sciences · 2025Review
- Machine learning combining external validation to explore the immunopathogenesis of diabetic foot ulcer and predict therapeutic drugs.PloS one · 2025Article
- Prevalence and risk factors of wound complications after transtibial amputation in patients with diabetic foot.World journal of diabetes · 2024Article
- Timing of Revascularization and Parenteral Antibiotic Treatment Associated with Therapeutic Failures in Ischemic Diabetic Foot Infections.Antibiotics (Basel, Switzerland) · 2023Article
- Correction of hyperglycemia after surgery for diabetic foot infection and its association with clinical outcomes.BMC research notes · 2022Article
- The association of chronic, enhanced immunosuppression with outcomes of diabetic foot infections.Endocrinology, diabetes & metabolism · 2022Article
- Nutritional Interventions May Improve Outcomes of Patients Operated on for Diabetic Foot Infections: A Single-Center Case-Control Study.Journal of diabetes research · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated if a chronic, enhanced immunosuppressed condition, beyond the immunodeficiency related to diabetes, is associated with clinical failures after combined surgical and medical treatment for diabetic foot infection (DFI). This is a case-control cohort study in a tertiary centre for diabetic foot problems, using case-mix adjustments with multivariate Cox regression models. Among 1013 DFI episodes in 586 patients (median age 67 years; 882 with osteomyelitis), we identified a chronic, enhanced immune-suppression condition in 388 (38%) cases: dialysis (85), solid organ transplantation (25), immune-suppressive medication (70), cirrhosis (9), cancer chemotherapy (15) and alcohol abuse (243). Overall, 255 treatment episodes failed (25%). By multivariate analysis, the presence (as compared with absence) of chronic, enhanced immune-suppression was associated with a higher rate of clinical failures in DFI cases (hazard ratio 1.5, 95% confidence interval 1.1-2.0). We conclude that a chronic, enhanced immune-suppressed state might be an independent risk factor for treatment failure in DFI. Validation of this hypothesis could be useful information for both affected patients and their treating clinicians.
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Registered trials
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