Risk Factors for Foot-Related Hospitalisations in Adults With and Without Diabetes: A Systematic Review.

INTRODUCTION

Foot-related conditions are a leading cause of all hospitalisations and amputations worldwide. Half of these foot-related hospitalisations are in people without diabetes. Yet, few studies seem to have explored risk factors for foot-related hospitalisations in populations with or without diabetes. This study aimed to systematically review studies investigating risk factors for hospitalisations caused by any foot-related conditions amongst any general community-dwelling adult populations (with or without diabetes).

METHODS

PubMed and Embase databases were searched for studies related to risk factors, foot-related conditions and hospitalisations published since 1st January 2000. Search results were screened for eligibility by two independent authors. Risk of bias was assessed using the Quality in Prognostic Studies tool, and data were extracted using a customised data extraction tool.

RESULTS

Fourteen studies from 7824 screened studies were included. Twelve studies investigated diabetes populations and two general (with and without diabetes) populations. All 14 studies investigated only for foot disease-related hospitalisation outcomes. Seven studies were rated as low risk of bias. Twenty-two independent risk factors were reported, including eight reported both in multiple studies and low risk of bias studies. Those eight risk factors were being male, having diabetes, increased HbA1c, insulin management, chronic kidney disease, peripheral neuropathy, peripheral artery disease and no footcare within 12 months.

CONCLUSIONS

This review suggests that the common risk factors for foot disease-related hospitalisations are being male, having diabetes, chronic kidney disease, peripheral neuropathy, peripheral artery disease and lack of footcare, particularly in diabetes populations. There were no studies investigating hospitalisations for other foot-related conditions and few in nondiabetes populations.