Anemia in patients with diabetic foot ulcer and its impact on disease outcome among Nigerians: Results from the MEDFUN study


Autoři: Ibrahim D. Gezawa aff001;  Ejiofor T. Ugwu aff002;  Ignatius Ezeani aff003;  Olufunmilayo Adeleye aff004;  Innocent Okpe aff005;  Marcelina Enamino aff006
Působiště autorů: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Bayero University, Kano, Nigeria aff001;  Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Enugu State University of Science and Technology, Enugu, Nigeria aff002;  Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Federal Medical Center, Umuahia, Nigeria aff003;  Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lagos State University, Lagos, Nigeria aff004;  Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Ahmadu Bello University, Zaria, Nigeria aff005;  Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Federal Medical Center, Keffi, Nigeria aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226226

Souhrn

Background

Diabetes is a life-long and debilitating disease that is fraught with both acute and chronic complications. Of particular concern to sufferers of the disease is the development of foot problems. These problems range from foot deformities to slowly healing or non-healing ulcers (that may necessitate amputation) and in the worst-case scenario, to death. Identification and prompt treatment of comorbid conditions, such as anemia may improve outcome in patients with diabetic foot ulcers (DFU). We determined the prevalence of anemia in Nigerians with DFU and its impact on disease outcome.

Methods

We prospectively followed 336 patients with diabetes hospitalized for DFU and managed by a multidisciplinary team until discharge or death. Demographic and diabetes-related information and ulcer characteristics were documented. We evaluated each patient for neuropathy, vasculopathy and medical co-morbidities. Relevant laboratory and imaging studies were performed. We present the results of the sub-group analysis of patients with anemia to determine its prevalence and impact on disease outcome in patients with DFU in the MEDFUN study.

Results

Anemia was detected in 180(53.6%) subjects with 88(48.9%) of them requiring blood transfusion. Significant demographic and clinical determinants of anemia were ulcer duration more than one month prior to hospitalization (p<0.009), PAD (p<0.001) and presence of gangrene (p<0.001). The comorbid conditions that were significantly associated with anemia included proteinuria (p<0.003), osteomyelitis (p<0.006), moderate (p<0.002) as well as severe (p<0.001) vascular stenosis, history of stroke (p<0.014) and renal impairment (p<0.002). Anemia was significantly associated with poor wound healing (p<0.009), amputation (p<0.036) and risk of death (p<0.034).

Conclusion

We detected anemia in more than half of our cohort with DFU. We found significant association between anemia and poor wound healing, amputation and mortality among our studied subjects. Future studies should explore whether prompt correction of anemia in subjects hospitalized for DFU would improve outcome.

Klíčová slova:

anémia – Inflammation – Nigeria – Stenosis – stroke – Ulcers – Wound healing


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Článek vyšel v časopise

PLOS One


2019 Číslo 12