Anemia in Patients With Diabetic Foot Ulcer

Abstract

The aim of this study was to describe the characteristics of diabetic foot ulcer (DFU) patients with anemia and assess the relationship between anemia and DFU outcome. A retrospective cohort study was conducted on patients with DFU who attended our hospital from May 2007 to September 2014. All of the variables in the DFU patients with and without anemia were compared. In this study, 353 subjects were included, anemia was present in 236 patients (66.9%). These patients were significantly male, more likely to be a smoker, had a lower level of serum albumin and worse kidney function, more likely to use at least 2 types of antibiotics and had a worse perfusion of the lower limb, a larger and deeper ulcer and a more severe infection. A multivariate analysis showed that male sex, lower serum albumin, and worse kidney function were independent predictors of anemia in DFU patients. Additionally, in multivariate models, anemia was one of the variables that was most significantly associated with adverse outcomes and with similar findings for secondary outcomes. Receiver operating characteristic analysis determined a hemoglobin cutoff of 12.3 g/dL (females) and 12.1 g/dL (males) to identify a high-risk population of DFU patients who would have adverse outcomes. So anemia is common in patients with DFU. Although typically mild or moderate, anemia has been associated with substantial morbidity and mortality in patients with DFU.