The clinical course and mortality of persons with diabetic Charcot foot.

INTRODUCTION

The aim was to study the mortality and the clinical course of diabetic Charcot foot.

METHODS

This was a retrospective cohort study including all persons with diabetes and a Charcot diagnosis from 2000 to 2016.

RESULTS

In the mortality sub-study, 164 persons had the Charcot diagnosis, 52 (31.1%) died in the follow-up period. The mortality rate was 4.6/100 person-years at risk. Rate ratios for death were insignificantly different among smokers and non-smokers, among persons with type 1 and type 2 diabetes, among persons with a diabetes duration below or above ten years and among persons with a glycated haemoglobin (HbA1c) level above or below 60 mmol/mol after adjustment for age and gender. In the clinical course sub-study, 114 persons with Charcot were identified whereof 97 (85%) had an active Charcot. The duration from start of symptoms to diagnosis was ten weeks, the treatment period was 7.5 months and 46 (40%) had bony prominences (rocker bottom) in the planta at follow-up.

CONCLUSIONS

The mortality rate among persons with Charcot was 4.6/person-years at risk, which was unaffected by smoking, diabetes type, diabetes duration and HbA1c level. The persons with Charcot had a long delay from symptom onset to diagnosis, a long treatment period and often developed complications.

FUNDING: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

TRIAL REGISTRATION: not relevant.