TY - Generic T1 - Low prevalence of previous lower limb revascularisation in patients with diabetes and acute Charcot foot: results from a case-control study. Y1 - 2015 A1 - Kris Doggen A1 - Hilde Beele A1 - Kevin Deschamps A1 - Isabelle Dumont A1 - Astrid Lavens A1 - Viviane Van Casteren A1 - Giovanni Matricali KW - charcot foot KW - diabetes KW - lower-limb revascularization AB -

Aim: Charcot foot is a rare but devastating complication of diabetes, leading to uncontrolled inflammation and high risk of osteolysis in its acute phase. Preserved local perfusion is a hypothesized prerequisite for the detrimental inflammatory response. We sought support for this hypothesis by studying the prevalence of previous lower limb revascularisation (LLR), as a marker of peripheral macroangiopathy, in patients with diabetes and Charcot foot.

Methods: Patients with diabetes and incident acute Charcot foot, but without a history of diabetic foot ulcers (DFU) (Charcot group, N=50) were retrospectively identified in a database used for quality of care monitoring in 36 Belgian specialized diabetic foot clinics in the period 2005-2011. [1] Patients without Charcot foot, but who had diabetic foot ulcers (DFU), served as controls (DFU group, N=3,147). Prevalence of previous LLR was compared between both groups using logistic regression.

Results: The Charcot group was significantly younger than the DFU group (59.1 vs. 69.1 years, P<0.001). Age-adjusted prevalence of previous LLR was significantly lower in the Charcot group than in the DFU group (3.5 vs. 29.8%, P<0.05), while the age-adjusted prevalence of coronary artery disease and stroke did not significantly differ (41.7 vs. 38.3%, P>0.05).

Conclusions: Charcot foot in diabetes only seems to occur in patients without a history of LLR. Despite the limitation of the cross-sectional nature of this study, our findings support the hypothesis that among patients with diabetes, Charcot foot occurs preferentially when lower limb perfusion is preserved.

 

[1] Doggen K, Diabetes Metab Res Rev. 2014;30(5):435-43.

JF - 7th International Symposium on the Diabetic Foot PB - International Working Group on the Diabetic Foot CY - The Hague, Netherlands CP - International Working Group on the Diabetic Foot U1 - 1049 U2 - 20/05/2015 ER -