Health-Related Quality of Life Predicts Major Amputation and Death, but Not Healing, in People With Diabetes Presenting With Foot Ulcers: The Eurodiale Study

• DOI: 10.2337/dc13-1212
• Publication Date: 2013-10-30T02:53:21Z
• Authors: Volkert Siersma; Hanne Thorsen; Per E. Holstein; Marleen Kars; Jan Apelqvist; Edward B. Jude; Alberto Piaggesi; Karel Bakker; Michael Edmonds; Alexandra Jirkovská; Didac Mauricio; Gunnel Ragnarson ...; Heinrich Reike; Maximilian Spraul; Luigi Uccioli; Vilma Urbancic; Kristien van Acker; Jeff van Baal; Nicolaas C. Schaper
• Keywords: Diabetic foot ulcer

OBJECTIVE Low health-related quality of life (HRQoL) has been consistently reported to be associated with poor prognosis for a variety health outcomes in various settings. We aimed evaluate whether HRQoL patients presenting new diabetic foot ulcers (DFUs) prognostic significance ulcer healing, major amputation, and death. RESEARCH DESIGN AND METHODS followed 1,088 DFUs treatment at one the 14 centers 10 European countries participating Eurodiale (European Study Group on Diabetes Lower Extremity) study, prospectively until healing (76.9%), amputation (4.6%), or death (6.4%) up maximum 1 year. At baseline, patient characteristics were recorded as well EQ-5D, standardized instrument consisting five domains visual analog scale use measure HRQoL. The influence EQ-5D was evaluated multivariable Cox regression analyses time-to-event data, adjusting baseline clinical comorbidities. RESULTS While predictive effects HRQoL, adjusted possible confounders, absent decreased especially physical domains, statistically significant (mobility, self-care, usual activities) (self-care, activities, pain/discomfort). CONCLUSIONS appears death, but high does not increase healing. Future studies into outcome are important attempts decrease failure mortality.