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Outcome of Ischemic Foot Ulcer in Diabetic Patients Who Had no Invasive Vascular Intervention.

Elgzyri, Targ LU ; Larsson, Jan ; Thörne, Johan LU ; Eriksson, Karl-Fredrik LU and Apelqvist, Jan LU (2013) In European Journal of Vascular and Endovascular Surgery 46(1). p.110-117
Abstract
OBJECTIVE/BACKGROUND: There is limited information regarding outcome in patients not available for revascularisation. Our aim was to identify factors related to ulcer healing in diabetic patients with severe peripheral arterial disease who were not available for revascularisation. METHODS: Diabetic patients with a foot ulcer, consecutively presenting at a multidisciplinary foot centre with systolic toe pressure <45 mmHg or an ankle pressure <80 mmHg were prospectively included. Patients who received revascularisation were excluded. All patients had continuous follow-up until healing or death. RESULTS: Out of 602 patients (median age: 76 years) included in this study, 50% healed either primarily (76%) or with a minor amputation (24%).... (More)
OBJECTIVE/BACKGROUND: There is limited information regarding outcome in patients not available for revascularisation. Our aim was to identify factors related to ulcer healing in diabetic patients with severe peripheral arterial disease who were not available for revascularisation. METHODS: Diabetic patients with a foot ulcer, consecutively presenting at a multidisciplinary foot centre with systolic toe pressure <45 mmHg or an ankle pressure <80 mmHg were prospectively included. Patients who received revascularisation were excluded. All patients had continuous follow-up until healing or death. RESULTS: Out of 602 patients (median age: 76 years) included in this study, 50% healed either primarily (76%) or with a minor amputation (24%). Seventeen percent of patients healed after major amputation and 33% died unhealed. By regression analysis, rest pain, impaired renal function, ischemic heart disease, cerebral vascular disease, extent of tissue destruction, and ankle pressure >50 mmHg affected the outcome of the ulcers. CONCLUSION: Diabetic patients with ischemic foot ulcers not available for revascularisations are not excluded from healing without major amputation. Factors strongly related to outcome were co-morbidity, severity of peripheral arterial disease, and extent of tissue destruction. Our findings reinforce the need for a classification system considering these factors at decision-making for vascular intervention. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Vascular and Endovascular Surgery
volume
46
issue
1
pages
110 - 117
publisher
Elsevier
external identifiers
  • wos:000321883200020
  • pmid:23642521
  • scopus:84879043841
  • pmid:23642521
ISSN
1532-2165
DOI
10.1016/j.ejvs.2013.04.013
language
English
LU publication?
yes
id
f899fb32-7296-4d87-afbe-059a8a9d2f37 (old id 3804918)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23642521?dopt=Abstract
date added to LUP
2016-04-01 10:59:14
date last changed
2024-04-07 22:52:12
@article{f899fb32-7296-4d87-afbe-059a8a9d2f37,
  abstract     = {{OBJECTIVE/BACKGROUND: There is limited information regarding outcome in patients not available for revascularisation. Our aim was to identify factors related to ulcer healing in diabetic patients with severe peripheral arterial disease who were not available for revascularisation. METHODS: Diabetic patients with a foot ulcer, consecutively presenting at a multidisciplinary foot centre with systolic toe pressure &lt;45 mmHg or an ankle pressure &lt;80 mmHg were prospectively included. Patients who received revascularisation were excluded. All patients had continuous follow-up until healing or death. RESULTS: Out of 602 patients (median age: 76 years) included in this study, 50% healed either primarily (76%) or with a minor amputation (24%). Seventeen percent of patients healed after major amputation and 33% died unhealed. By regression analysis, rest pain, impaired renal function, ischemic heart disease, cerebral vascular disease, extent of tissue destruction, and ankle pressure &gt;50 mmHg affected the outcome of the ulcers. CONCLUSION: Diabetic patients with ischemic foot ulcers not available for revascularisations are not excluded from healing without major amputation. Factors strongly related to outcome were co-morbidity, severity of peripheral arterial disease, and extent of tissue destruction. Our findings reinforce the need for a classification system considering these factors at decision-making for vascular intervention.}},
  author       = {{Elgzyri, Targ and Larsson, Jan and Thörne, Johan and Eriksson, Karl-Fredrik and Apelqvist, Jan}},
  issn         = {{1532-2165}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{110--117}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Vascular and Endovascular Surgery}},
  title        = {{Outcome of Ischemic Foot Ulcer in Diabetic Patients Who Had no Invasive Vascular Intervention.}},
  url          = {{http://dx.doi.org/10.1016/j.ejvs.2013.04.013}},
  doi          = {{10.1016/j.ejvs.2013.04.013}},
  volume       = {{46}},
  year         = {{2013}},
}