What question did this study set out to answer?

This study aims to evaluate the impact of frailty on healing and long-term mortality in diabetic foot ulcer disease (DFUD).

June 7, 2026

1458-P: Clinical Frailty Is a Major Determinant of Long-Term Survival in People with Diabetic Foot Ulcer Disease

Key Points

This study aims to evaluate the impact of frailty on healing and long-term mortality in diabetic foot ulcer disease (DFUD).
Retrospective analysis of 283 patients attending a tertiary DFU service from 01/01/2015 to 31/12/2016
Assessment of demographics, comorbidities, ulcer severity, and frailty using established scales
Linear regression for healing time and multivariable logistic regression for mortality prediction.
At 10-year follow-up, 69.3% of patients had died, with older age and higher frailty noted in non-survivors
Higher frailty and ulcer severity independently delayed healing, with significant odds ratios for frailty and comorbidity as mortality predictors
Frailty (OR 1.66, 95% CI 1.09-2.53) and QRISK3 score were significant independent predictors of long-term mortality.

Abstract

Introduction and Objective: Diabetic foot ulcer disease (DFUD) carries a very high mortality. Identifying predictors of long-term survival is crucial for risk stratification and individualising treatment. Cardiovascular and renal risk factors are recognised in DFUD, but the impact of frailty is unclear. We evaluated demographic, clinical and frailty-related predictors of delayed healing and all-cause mortality in people with DFU. Methods: We retrospectively analysed 283 consecutive patients attending a tertiary DFU service between 01/01/2015 and 31/12/2016. Demographics, comorbidities (Charlson Comorbidity Index), ulcer severity (SINBAD score) and frailty (Clinical Frailty Scale CFS, 1 = very fit to 9 = terminally ill) were recorded. Associations with time to healing were examined using linear regression, and predictors of 10-year mortality using multivariable logistic regression adjusted first for demographic and non-modifiable factors, then for modifiable clinical factors. Results: At 10-year follow-up, 69.3% of patients (n = 196) had died. Non-survivors were older (73.7 vs 60.7 years; p 0.001), frailer (CFS 5.2 vs 3.8; p 0.001) and had greater comorbidity (Charlson Index 7.6 vs 4.8; p 0.001) than survivors. Higher frailty (β = 0.20; p = 0.035) and ulcer severity (β = 0.24; p = 0.002) independently delayed healing. In multivariable models, frailty (OR 1.66, 95% CI 1.09-2.53), QRISK3 score (OR 1.05, 95% CI 1.01-1.09), comorbidity (OR 1.29, 95% CI 1.02-1.63) and HbA1c (OR 1.02, 95% CI 1.01-1.04) independently predicted mortality. Conclusion: Frailty and ulcer severity(SINBAD Score)independently predicted delayed healing of DFU, while frailty, cardiovascular risk and comorbidity burden independently predicted long-term mortality. Routine assessment of frailty in people with DFUD, and tailoring interventions to preserve or enhance physical function, may improve healing and ultimately improve survival. Disclosure N. Andrzejowska: None. M. Goonoo: None. K. Low: None. T.M. Azorji: None. M. Baidas: None. M.A. Abera: None. S. Caunt: None. D. Selvarajah: Speaker's Bureau; Current; Grünenthal Group. Research Support; Current; Abbott Diabetes, Tandem Diabetes Care, Inc., Dexcom, Inc. R. Gandhi: None. S. Tesfaye: Advisory Panel; Current; AstraZeneca, Nevro Corp. Speaker's Bureau; Current; Novo Nordisk, Viatris Inc., Medtronic. Advisory Panel; Current; Bayer AG, Wörwag Pharma GmbH Ended; Procter & Gamble, Grünenthal Group.

Ask AI

Helpful

Bookmark