Despite Higher Complexity, Research Reveals Better Outcomes For DFU

Great work from our long-time SALSAmigos Akturk and coworkers from the Netherlands.¹ The bottom line they noted more complicated patients (ie about five times the rate of patients on dialysis), but better overall outcomes of people treated with diabetic foot ulcer (DFU) from 2003-2004 to 2014-2018.

The authors duly note that rates of diabetes and patients with diabetic foot disease continues to rise worldwide. They set out to study two groups of patients, fifteen years apart, for patient characteristics and outcomes of those with DFU. Each cohort had 12 months follow up. Although the more recent cohort (2014-2018) was significantly older and had much higher prevalence of end-stage renal disease, they also exhibited higher healing rates, longer days in ulcer remission, fewer minor amputations.¹

I believe strongly that the rise in team care has had a significant impact on treating more complex patients. I think that more complex patients (ie those with more end stage disease like those on renal replacement) are also reflections on better care overall. People are living longer with complications of chronic diseases. While this should be celebrated, we shouldn't rest on our laurels! Indeed, people with these complications can likely have many of these dramatically delayed or prevented way upstream! We continue onward and upward!

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/10/25/more-reason-for-hope-improved-outcomes-in-patients-with-diabetic-foot-ulcers-over-the-past-decade-despite-more-complex-patients/. It is adapted with permission from the author.

Reference

1. Akturk A, van Netten JJ, Vermeer M, et al. Improved outcomes in patients with diabetic foot ulcers despite of differences in baseline characteristics. Wound Repair Regen. 2021. Online ahead of print. doi: 10.1111/wrr.12976.