Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: The BRAZUPA study

dc.contributor.authorParisi, Maria Candida R.
dc.contributor.authorNeto, Arnaldo Moura
dc.contributor.authorMenezes, Fabio H.
dc.contributor.authorGomes, Marilia Brito
dc.contributor.authorTeixeira, Rodrigo Martins
dc.contributor.authorDe Oliveira, José Egídio Paulo
dc.contributor.authorPereira, Joana Rodrigues Dantas
dc.contributor.authorFonseca, Reine Marie Chaves
dc.contributor.authorGuedes, Lorena Barreto Arruda
dc.contributor.authorE Forti, Adriana Costa
dc.contributor.authorDe Oliveira, Ana Mayra Andrade
dc.contributor.authorDe Medeiros Nóbrega, Marta Barreto
dc.contributor.authorColares, Víctor Nóbrega Quintas
dc.contributor.authorSchmid, Helena
dc.contributor.authorNienov, Otto Henrique
dc.contributor.authorNery, Marcia
dc.contributor.authorFernandes, Túlio Diniz
dc.contributor.authorPedrosa, Hermelinda C.
dc.contributor.authorSchreiber, Cristina
dc.contributor.authorRonsoni, Marcelo
dc.contributor.authorRezende, Karla Freire
dc.contributor.authorQuilici, Maria Teresa Verrone
dc.contributor.authorVieira, Alexandre Eduardo Franzin
dc.contributor.authorDe Macedo, Geisa Maria Campos
dc.contributor.authorStuchi-Perez, Eliana Gabas
dc.contributor.authorDinhane, Kandir Genésio Innocenti [UNESP]
dc.contributor.authorPace, Ana Emilia
dc.contributor.authorDe Freitas, Maria Cristina Foss
dc.contributor.authorCalsolari, Maria Regina
dc.contributor.authorSaad, Mario José Abdalla
dc.contributor.institutionUniversidade Estadual de Campinas (UNICAMP)
dc.contributor.institutionState University of Rio de Janeiro
dc.contributor.institutionFederal University of Rio de Janeiro
dc.contributor.institutionCentre for Diabetes and Endocrinology in the State of Bahia (CEDEBA)
dc.contributor.institutionCentro Integrado de Diabetes e Hipertensão Do Ceará
dc.contributor.institutionState University of Feira de Santana
dc.contributor.institutionFederal University of Campina Grande
dc.contributor.institutionFederal University of Rio Grande Do sul
dc.contributor.institutionSanta Casa de Porto Alegre
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionHospital Regional de Taguatinga
dc.contributor.institutionUniversidade Federal de Santa Catarina (UFSC)
dc.contributor.institutionUniversidade Federal de Sergipe (UFS)
dc.contributor.institutionPontifícia Universidade Católica de Sorocaba
dc.contributor.institutionHospital Agamenon Magalhães
dc.contributor.institutionFaculdade de Medicina de Catanduva
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionSanta Casa de Belo Horizonte
dc.date.accessioned2018-12-11T17:23:19Z
dc.date.available2018-12-11T17:23:19Z
dc.date.issued2016-01-01
dc.description.abstractBackground: Studies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation. Methods: This study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications. Results: Patients with ulcer had longer disease duration (17.2 ± 9.9 vs. 13.2 ± 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 ± 2.03 vs. 8.35 ± 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2-3.7), smoking (OR 1.78; 95 % CI 1.09-2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31-44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47-3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08-2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65-13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2-3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01-11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43-112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14-0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1-4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67-19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64-7.33). There was no association between either outcome and ethnicity. Conclusions: Ulcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.en
dc.description.affiliationFaculty of Medical Sciences State University of Campinas
dc.description.affiliationUnity of Diabetes State University of Rio de Janeiro
dc.description.affiliationDepartment of Nutrology Federal University of Rio de Janeiro
dc.description.affiliationCentre for Diabetes and Endocrinology in the State of Bahia (CEDEBA)
dc.description.affiliationCentro Integrado de Diabetes e Hipertensão Do Ceará
dc.description.affiliationState University of Feira de Santana
dc.description.affiliationFederal University of Campina Grande
dc.description.affiliationHospital das Clínicas de Porto Alegre Federal University of Rio Grande Do sul
dc.description.affiliationSanta Casa de Porto Alegre
dc.description.affiliationHospital das Clínicas da Faculdade de Medicina Universidade de São Paulo
dc.description.affiliationHospital Regional de Taguatinga
dc.description.affiliationFaculdade de Medicina Federal University of Santa Catarina
dc.description.affiliationFederal University of Sergipe
dc.description.affiliationPontifícia Universidade Católica de Sorocaba
dc.description.affiliationDivision of Endocrinology Hospital Agamenon Magalhães
dc.description.affiliationFaculdade de Medicina de Catanduva
dc.description.affiliationFaculdade de Medicina de Botucatu UNESP
dc.description.affiliationUniversidade de São Paulo Faculdade de Medicina
dc.description.affiliationSanta Casa de Belo Horizonte
dc.description.affiliationUnespFaculdade de Medicina de Botucatu UNESP
dc.identifierhttp://dx.doi.org/10.1186/s13098-016-0126-8
dc.identifier.citationDiabetology and Metabolic Syndrome, v. 8, n. 1, 2016.
dc.identifier.doi10.1186/s13098-016-0126-8
dc.identifier.file2-s2.0-85007542914.pdf
dc.identifier.issn1758-5996
dc.identifier.scopus2-s2.0-85007542914
dc.identifier.urihttp://hdl.handle.net/11449/176971
dc.language.isoeng
dc.relation.ispartofDiabetology and Metabolic Syndrome
dc.relation.ispartofsjr0,943
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectAmputation
dc.subjectBrazil
dc.subjectDiabetes
dc.subjectRisk factors for ulcer
dc.subjectSevere neuropathy
dc.titleBaseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: The BRAZUPA studyen
dc.typeArtigo

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