• Sophia Rossboth, Benedikt Rossboth, Hans Schoenherr, Christian Ciardi, Monika Lechleitner, and Willi Oberaigner.
• Research Unit for Diabetes Epidemiology, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria. sophia.rossboth@edu.umit.at.
• Wien. Klin. Wochenschr. 2022 Jan 1; 134 (1-2): 7-17.

BackgroundDiabetic foot complications, one of the most severe late complications of type 2 diabetes mellitus, are associated with a tremendous personal and financial burden. In order to drive the prevention of diabetic foot complications forward and facilitate early detection and personalized screening of high-risk patients, longitudinal studies are needed to identify risk factors associated with diabetic foot complications in large patient datasets.MethodsThis is a retrospective cohort study on 3002 patients with type 2 diabetes mellitus aged ≥ 18 years without prior foot complications. The data were collected between 2006 and 2017 in an Austrian hospital department specialized for diabetic patients. In addition to a univariate Cox regression analysis, multivariate Cox regression models were established to identify independent risk factors associated with diabetic foot complications and adjust for potential confounders.ResultsWe observed a total of 61 diabetic foot complications in 3002 patients. In the multivariate Cox regression model, significant risk factors (hazard ratio, 95% confidence interval) for foot complications were age at diagnosis > 70 years (3.39, 1.33-8.67), male gender (2.55, 1.42-4.55), neuropathy (3.03, 1.74-5.27), peripheral arterial disease (3.04, 1.61-5.74), hypertension > 10 years after diagnosis (2.32, 1.09-4.93) and HbA1c > 9% (2.44, 1.02-5.83).ConclusionThe identified risk factors for diabetic foot complications suggest that personalized early detection of patients at high risk might be possible by taking the patient's clinical characteristics, medical history and comorbidities into account. Modifiable risk factors, such as hypertension and high levels of blood glucose might be tackled to reduce the risk for diabetic foot complications.© 2021. Springer-Verlag GmbH Austria, part of Springer Nature.

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