Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
Morbidity and Mortality Rates in People with Diabetes Mellitus With an Active Charcot's Neuro-Osteoarthropathy: A 15-Year Single-Center Retrospective Analysis.
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Patel Dipen, Gooday Catherine, Nunney Ian, Dhatariya Ketan
Аннотация
INTRODUCTION: Diabetes related Charcot neuro-osteoarthropathy (CN) of the foot is associated with increased risks of amputation and premature mortality. We aimed to report the amputation and mortality rates of people with active CN and identify participant and CN characteristics associated with these adverse outcomes.
METHODS: A single-center retrospective study. Participants were included if they were diagnosed with an active CN with type 1 or type 2 diabetes mellitus presenting to a specialist foot clinic between January 2007 and September 2022. Participant and CN characteristics were analyzed to determine relationships with amputation or mortality.
RESULTS: 186 participants were included with 195 CN feet. Median follow-up was 8.2 years (IQR 5.3, 12.2). Male sex (p = 0.026) and previous amputation (p = 0.003) were associated with a significantly increased risk of amputation. The 1-year, 5-year, and 10-year mortality rates were 2.7% (5/186), 18.9% (23/122), and 40% (24/60), respectively. Previous amputation and worsening chronic kidney disease stage were associated with a significantly increased mortality risk (p = 0.005 and p = 0.027, respectively).
CONCLUSIONS: Participants with CN had high amputation and mortality rates. The causes of death were multifactorial, suggesting clinicians should focus on early aggressive multiple risk factor intervention to reduce these adverse outcomes.
METHODS: A single-center retrospective study. Participants were included if they were diagnosed with an active CN with type 1 or type 2 diabetes mellitus presenting to a specialist foot clinic between January 2007 and September 2022. Participant and CN characteristics were analyzed to determine relationships with amputation or mortality.
RESULTS: 186 participants were included with 195 CN feet. Median follow-up was 8.2 years (IQR 5.3, 12.2). Male sex (p = 0.026) and previous amputation (p = 0.003) were associated with a significantly increased risk of amputation. The 1-year, 5-year, and 10-year mortality rates were 2.7% (5/186), 18.9% (23/122), and 40% (24/60), respectively. Previous amputation and worsening chronic kidney disease stage were associated with a significantly increased mortality risk (p = 0.005 and p = 0.027, respectively).
CONCLUSIONS: Participants with CN had high amputation and mortality rates. The causes of death were multifactorial, suggesting clinicians should focus on early aggressive multiple risk factor intervention to reduce these adverse outcomes.