Background Although ageing could increase the risk of delayed healing in diabetic foot ulcers (DFUs) patients, data from middle-aged patients remains greatly limited. The purpose of this study was to explore the clinical phenotypes, outcomes and predictive factors of DFU in middle-aged patients. Methods A retrospective cohort study conducted with 422 consecutive inpatients with DFUs who visited our hospital between May 2010 and September 2017; participants were recruited and assigned according to age to either the middle-aged group or the elderly group. The Demographics, ulcer characteristics, comorbidities and diabetes complications, laboratory tests, socioeconomic data and final outcomes were collected. Moreover, predictive factors of adverse outcomes in middle-aged DFUs patients were assessed. Results Middle-aged patients were more likely to have worse lifestyle and glucose control, were more likely to have microangiopathy as a complication, and tended to have larger and deeper ulcers; however, these patients also had higher rates of healing and lower rates of mortality and major amputaion than elderly patients. Severe infection,living alone,current smoking cigarettes, and having a high white blood cell count were independent risk factors for adverse outcomes in middle-aged patients. Conclusions DFUs are relatively common in middle-aged patients with diabetes, and these patients have unique clinical phenotypes and risk profiles. Nonetheless, further investigation is needed to clarify whether intervention targeting these easily recognizable risk factors can improve healing and survival rates in middle-aged DFU patients.

中文翻译：

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中年糖尿病足溃疡患者的表型和结局：一项回顾性队列研究

背景虽然衰老可能会增加糖尿病足溃疡（DFU）患者延迟愈合的风险，但来自中年患者的数据仍然非常有限。本研究的目的是探讨中年患者 DFU 的临床表型、结局和预测因素。方法对2010年5月至2017年9月期间就诊于我院的连续422例DFU住院患者进行回顾性队列研究。招募参与者并根据年龄分配为中年组或老年组。收集人口统计学、溃疡特征、合并症和糖尿病并发症、实验室测试、社会经济数据和最终结果。此外，还评估了中年 DFU 患者不良结局的预测因素。结果中年患者的生活方式和血糖控制更差，更容易出现微血管病变并发症，并且溃疡往往更大更深；然而，与老年患者相比，这些患者的治愈率更高，死亡率和大截肢率更低。严重感染、独居、吸烟、白细胞计数高是中年患者不良结局的独立危险因素。结论 DFU在中年糖尿病患者中较为常见，且具有独特的临床表型和风险特征。尽管如此，还需要进一步研究来明确针对这些容易识别的危险因素的干预措施是否可以提高中年 DFU 患者的治愈率和生存率。