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Cited by 532

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Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom

Walsh, J. W., Hoffstad, O. J., Sullivan, M. O., Margolis, D. J.·2016·Diabetic Medicine

Abstract

Aims: The presence of diabetic foot ulcers is strongly associated with an increased risk of death. In this study, we investigate whether the effects of diabetes‐associated complications can explain the apparent relationship between diabetic foot ulcers and death. Methods: We analysed data from 414 523 people with diabetes enrolled in practices associated with The Health Improvement Network in the United Kingdom. Our methods were designed to control for potential confounders in order to isolate the relationship between diabetic foot ulcers and death. Using proportional hazards models and the area under the receiver operator curve, we evaluated the effects of diabetic foot ulcers and the covariates on death. Results: Among the patients, 20 737 developed diabetic foot ulcers; 5.0% of people with new ulcers died within 12 months of their first foot ulcer visit and 42.2% of people with foot ulcers died within 5 years. After controlling for major known complications of diabetes that might influence mortality, the correlation between diabetic foot ulcers and death remained strong with a fully adjusted hazard ratio of 2.48 (95% confidence interval: 2.43, 2.54). Geographic variance existed but was not spatially associated. Conclusions: Diabetic foot ulcers are linked to an increased risk of death. This cannot be explained by other common risk factors. These results suggest that either there are major unknown risk factors associated with both diabetic foot ulcers and death, or that diabetic foot ulceration itself is a serious threat, which seems unlikely. A diabetic foot ulcer should be seen as a major warning sign for mortality, necessitating closer medical follow‐up.

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Metadata

Authors
Walsh, J. W., Hoffstad, O. J., Sullivan, M. O., & Margolis, D. J.
Venue
Diabetic Medicine
Publisher
Wiley
Published
2016-01-10
Volume
33
Issue
11
Pages
1493-1498
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
OpenAlex
W2202835946
Cited by
532
References
21
FWCI
13.42
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom. https://app.cochat.ai/papers/10.1111/dme.13054
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Walsh, J. W., Hoffstad, O. J., Sullivan, M. O., & Margolis, D. J. (2016). Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom. Diabetic Medicine. https://doi.org/10.1111/dme.13054

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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