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In blood we trust: anemia as a negative healing prognostic factor in diabetic foot patients

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Abstract

Aim

Anemia has been associated with severity of diabetic foot (DF) disease. Our study aimed to evaluate whether the presence of anemia could decrease the healing chances in DF.

Methods

We retrospectively analyzed all patients admitted in our department in 2021 for DF, dividing them according to presence (Group A) or absence (Group B) of anemia. Groups were compared for clinical and demographic characteristics, procedures and outcomes: healing rate (HR) at 6 months, healing time (HT) and recurrence rate (RR) at 12 months.

Results

We sorted out data from 196 consecutive patients: 114 (58%) in Group A and 82 (42%) in B. Group A had a higher male prevalence and a longer duration of disease. Group A showed lower hemoglobin concentration (10.3 ± 1.3 g/dL vs 13.1 ± 1.4 g/dL, p < 0.002) and red blood cells count (3.4 ± 0.5 × 106/mL vs 4.8 ± 0.6 × 106/mL, p = 0.004). Group A presented a lower HR (55.2% vs 76.8%, p = 0.0028), no differences in HT and a higher RR (23.6% vs 17.1%, p < 0.02). Cox’s logistic regression on healing confirmed the negative impact of anemia: hazard ratio 2.8 (CI 95% 1.4–5.4, p = 0.0037).

Conclusions

Anemia is frequent in DF and associates to a reduction in healing chances and an increase in recurrences representing an independent predictor of healing failure.

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Funding

No fundings were used to conduct this study.

Author information

Authors and Affiliations

  1. Diabetic Foot Section – Pisa University Hospital, Via Paradisa 2, 56126, Pisa, Italy

    Francesco Giangreco, Elisabetta Iacopi, Vittorio Malquori, Letizia Pieruzzi, Chiara Goretti & Alberto Piaggesi

Authors
  1. Francesco Giangreco
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  2. Elisabetta Iacopi
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  3. Vittorio Malquori
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  4. Letizia Pieruzzi
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  5. Chiara Goretti
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  6. Alberto Piaggesi
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Contributions

AP and EI conceived of and designed the study, FG and EI acquired and analyzed data, AP, EI, and FG wrote and reviewed the manuscript. VM acquired and reviewed data and reviewed the manuscript. CG and LP reviewed the manuscript. AP is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Alberto Piaggesi.

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Conflict of interest

No potential conflicts of interest relevant to this article were reported.

Informed consent

All patients admitted in our hospital signed a consent form for disclosure of their clinical data and results for clinical and research purposes.

Ethical approval

As per local ethical and good clinical practice rules in our university hospital retrospective analysis of data of admitted patients in aggregate form does not need preventive approval from ethical committee.

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Managed By Antonio Secchi.

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Giangreco, F., Iacopi, E., Malquori, V. et al. In blood we trust: anemia as a negative healing prognostic factor in diabetic foot patients. Acta Diabetol 61, 245–251 (2024). https://doi.org/10.1007/s00592-023-02188-8

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  • DOI: https://doi.org/10.1007/s00592-023-02188-8

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