Elderly individuals with diabetes and foot ulcer have a probability for healing despite extensive comorbidity and dependency. (4th March 2021)

• Record Type: Journal Article
• Authors: Gershater, Magdalena Annersten; Apelqvist, Jan
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 21:Number 2(2021)
• Page Start: 277
• Page End: 284
• Publication Date: 2021-03-04
• Subjects: Amputation -- complications -- diabetes mellitus -- diabetic foot ulcers -- healing -- neuropathy -- peripheral vascular disease -- home nursing; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2020.1773804
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Background: Limited scientific evidence for prevention and treatment of diabetic foot ulcers in elderly with comorbidities. Aim: To explore patient-related factors and outcomes in patients ≥75 years with diabetes and a foot ulcer. Method: Sub-analysis of consecutively presenting patients ≥75 years (N = 1008) from a previous study on 2, 480 patients with diabetic foot ulcer treated in a multidisciplinary system until healing. Patient characteristics: age – 81(75–96); diabetes type 2–98.7%; male/female – 49/51%; living with a spouse – 47%; nursing home 16%; or with home nursing 64%. Result: Primary healing was achieved in 54%, minor amputation 8%, major amputation 9%, auto-amputation 2%, and 26% of the patients died unhealed. Among the oldest (88–96 years), 31% healed without any amputation. Extensive comorbidities were frequent: neuropathy 93%, visual impairment 73%, cardiovascular disease 60%, cerebrovascular disease 34%, and severe peripheral disease in 29% of the patients. Out of patients (80%) living in institutions or dependent on home nursing, 56% healed without amputation, compared to 44% of patients living in their own home without any support from social services or home nursing. Conclusion: Healing without major amputation was achieved in 84% of surviving patients ≥75 years, despite extensive comorbidity and dependency.