Elderly individuals with diabetes and foot ulcer have a probability for healing despite extensive comorbidity and dependency

Abstract

Background: Limited scientific evidence for prevention and treatment of diabetic foot ulcers in elderly with comorbidities. Aim: To explore patient-related factors and outcomes in patients ≥75 years with diabetes and a foot ulcer. Method: Sub-analysis of consecutively presenting patients ≥75 years (N = 1008) from a previous study on 2,480 patients with diabetic foot ulcer treated in a multidisciplinary system until healing. Patient characteristics: age–81(75–96); diabetes type 2–98.7%; male/female–49/51%; living with a spouse–47%; nursing home 16%; or with home nursing 64%. Result: Primary healing was achieved in 54%, minor amputation 8%, major amputation 9%, auto-amputation 2%, and 26% of the patients died unhealed. Among the oldest (88–96 years), 31% healed without any amputation. Extensive comorbidities were frequent: neuropathy 93%, visual impairment 73%, cardiovascular disease 60%, cerebrovascular disease 34%, and severe peripheral disease in 29% of the patients. Out of patients (80%) living in institutions or dependent on home nursing, 56% healed without amputation, compared to 44% of patients living in their own home without any support from social services or home nursing. Conclusion: Healing without major amputation was achieved in 84% of surviving patients ≥75 years, despite extensive comorbidity and dependency.