Prognosis of the outcome of severe diabetic foot ulcers with multidisciplinary care

Luz Marina Alfonso Dutra,1 Manuela Costa Melo,2 Mirian Conceição Moura,3 Lílian Assumpção Paes Leme,4 Marta Rodrigues De Carvalho,3 Andre Neves Mascarenhas,4 Maria Rita Carvalho Garbi Novaes11Department of Health Sciences, University of Brasília, Brasília, Federal District, Brazil; 2Departament of Nursing, Higher School of Health Sciences, Brasília, Federal District, Brazil; 3Department of Medicine, Higher School of Sciences and Hospital of the Secretary of Health of the Federal District, Clinical Neurophysiologist, Brasília, Federal District, Brazil; 4Department of Endocrinology, Regional Hospital of Asa Norte, Brasília, Federal District, BrazilBackground: Approximately 2–4% of individuals worldwide with diabetes mellitus have foot ulcers. This study aims to assess the factors affecting the outcomes of severe foot ulcers in diabetic individuals.Methods: An analytical prospective cohort study was conducted from March 1st, 2015, to March 1st, 2017. A total of 34 individuals was selected. The study included patients with foot ulcers below the ankle who were at risk of amputation. All tests used a <5% level of significance and confidence interval of 95%. A Pearson’s chi-squared test and binary multiple regression were performed to assess the factors related to healing.Results: Only 11.7% of the individuals required amputation; ulcers classified as 2/B according to the University of Texas Diabetic Foot Ulcer Classification System healed before the 1/B ulcers. Neuropathic ulcers were the most prevalent (58.8%); 61.8% healed after 1 year. Most of the individuals were overweight, 47.1% had reduced glomerular filtration rates, and 78.8% had glycated hemoglobin >7%. Body mass index and osteomyelitis were the two significant variables in logistic regression.Conclusions: In this study, osteomyelitis was the main complication related to the risk of amputation, and elevated body mass index and osteomyelitis were the significant factors that induced a slower healing time.Keywords: diabetes mellitus, diabetic foot, diabetes complications, multidisciplinary car