Age-related Phenotypes And Outcomes In Young And Middle-aged Patients With Diabetic Foot Ulcers

Objectives:The aim of this study was to explore the clinical phenotypes,outcomes and predictive factors of diabetic foot ulcers(DFUs)in young and middle-aged patients,in order to improve prognosis of those subjects.Methods:A retrospective cohort study was conducted with 422 consecutive patients with DFUs who visited our hospital between May 2007 and September 2015;participants were recruited and assigned according to age to either the young and middle-aged group or the elderly group.The demographics,ulcer characteristics,comorbidities and complications associated with diabetes,laboratory tests,socioeconomic data and final outcomes were compared between the two groups.Multivariable logistic regression analysis was performed to assess the factors that were predictive of adverse outcomes.Results:The young and middle-aged patients accounted for 41.4%of the total number of patients.These patients were more likely to smoke and consume alcohol,had higher levels of fasting plasma glucose and glycated haemoglobin,were more likely have diabetic retinopathy and peripheral neuropathy as a complication,and tended to have larger and deeper ulcers;however,ultimately,these patients also had higher rates of healing and lower rates of mortality than the elderly patients.Additionally,having a high white blood cell count,having a severe infection,smoking cigarettes,and living alone were independent risk factors for adverse outcomes in young and middle-aged patients.Conclusion:DFUs were common in young and middle-aged patients,and these patients had unique clinical phenotypes and risk profiles.Nonetheless,further investigation is needed to clarify whether intervention targeting these easily recognizable and modifiable risk factors can improve healing and survival rates in younger DFU patients.