TY - JOUR
T1 - Hospitalization for Charcot neuroarthropathy in diabetes
T2 - A population study in Italy
AU - Anichini, Roberto
AU - Policardo, Laura
AU - Lombardo, Flavia Lucia
AU - Salutini, Elisabetta
AU - Tedeschi, Anna
AU - Viti, Secondina
AU - Francia, Piergiorgio
AU - Brocco, Enrico
AU - Maggini, Marina
AU - Seghieri, Giuseppe
AU - De Bellis, Alessandra
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Aims To provide data on hospitalization and incidence rates of Charcot neuroarthropathy (CN) and its relation to lower limbs’ amputations/revascularizations in population with diabetes of Italy as well as of one of its regions (Tuscany). Methods Hospitalizations with CN diagnosis (codes ICD-9-CM: 7130, 7135, 7138) have been recorded in people with diabetes over years 2003–2013 in Italy and 2008–2015 in Tuscany. Amputations, peripheral vascular disease, revascularizations and infections were likewise evaluated. Results Between 2003 and 2013 CN hospitalizations were very infrequent in Italy ranging between 14 × 100,000 and 11 × 100,000 patients with diabetes. In Tuscany they declined to a minimum of 7 × 100,000 patients in 2015, after a previous increase to a maximum of 22 × 100,000 (p = NS for both). Yearly CN incidence remained constant in Italy, declining in Tuscany to a minimum of 3.4 × 100,000 diabetic patients in 2015 (p = 0.047). CN patients were younger and with longer length of hospital stay than those with non-Charcot diabetic foot (p < 0.05 for both). Amputation and infection rates were manifold higher in CN patients than in those with non-Charcot diabetic foot, while the revascularization rate was similar in both. Conclusions Over last decade, in Italy and Tuscany yearly CN incidence and hospitalization rates concerned only a small percentage of patients, remaining constant over years and declining in Tuscany in the last couple of years. CN was significantly associated to younger age, longer hospital stay and greater risk of amputations and infections while the need of revascularization was similar to that of non-Charcot diabetic foot.
AB - Aims To provide data on hospitalization and incidence rates of Charcot neuroarthropathy (CN) and its relation to lower limbs’ amputations/revascularizations in population with diabetes of Italy as well as of one of its regions (Tuscany). Methods Hospitalizations with CN diagnosis (codes ICD-9-CM: 7130, 7135, 7138) have been recorded in people with diabetes over years 2003–2013 in Italy and 2008–2015 in Tuscany. Amputations, peripheral vascular disease, revascularizations and infections were likewise evaluated. Results Between 2003 and 2013 CN hospitalizations were very infrequent in Italy ranging between 14 × 100,000 and 11 × 100,000 patients with diabetes. In Tuscany they declined to a minimum of 7 × 100,000 patients in 2015, after a previous increase to a maximum of 22 × 100,000 (p = NS for both). Yearly CN incidence remained constant in Italy, declining in Tuscany to a minimum of 3.4 × 100,000 diabetic patients in 2015 (p = 0.047). CN patients were younger and with longer length of hospital stay than those with non-Charcot diabetic foot (p < 0.05 for both). Amputation and infection rates were manifold higher in CN patients than in those with non-Charcot diabetic foot, while the revascularization rate was similar in both. Conclusions Over last decade, in Italy and Tuscany yearly CN incidence and hospitalization rates concerned only a small percentage of patients, remaining constant over years and declining in Tuscany in the last couple of years. CN was significantly associated to younger age, longer hospital stay and greater risk of amputations and infections while the need of revascularization was similar to that of non-Charcot diabetic foot.
KW - Amputations
KW - Charcot neuroarthropathy
KW - Diabetic foot
KW - Hospitalization rate
KW - Population study
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U2 - 10.1016/j.diabres.2017.03.029
DO - 10.1016/j.diabres.2017.03.029
M3 - Article
C2 - 28500867
AN - SCOPUS:85019108358
VL - 129
SP - 25
EP - 31
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
ER -