Background

Five-year mortality and amputation frequencies after new-onset diabetic ulceration have been reported up to 55% and 74%, respectively. for patients with lower-extremity amputation. Following Charcot arthropathy, these frequencies were reported with wide variations. The aim of this meta-analysis is to provide a quantitative evaluation of amputation and mortality frequencies in a diabetic patient with a Charcot foot arthropathy.

Methods

Electronic search strategy was applied on Medline, Web of Science, Cochrane Library and Google Scholar since inception to December 2021. Extracted data included study design, sample and patients characteristics, diabetes type and duration, lab results, ulcers at diagnosis, co-morbidities and follow up period. Meta-analysis reporting random-effects values was used to generate the weights results.

Results

A total of 16 studies were included in the quantitative meta-analysis with a pooled sample of 2250 patients with 2272 Charcot feet. Two studies including 255 patients yielded a 1-year mortality frequency of 4% (95% CI = 0.018–0.065). Seven studies including 1706 patients reported a 5-year mortality frequency of 24.5% (95% CI = 0.172–0.326, I² = 88.5%). Four studies including 277 patients yielded a seven plus year mortality frequency of 16% (95% CI = 0.065–0.289, I² = 84.3%). Ten studies including 871 foot yielded an amputation frequency of 15% (95% CI = 0.067–0.258, I² = 93.6%) where 9% where major amputations (95% CI = 0.062–0.127, I² = 60%) and 5% were minor amputations (95% CI = 0.004–0.126, I² = 94.7%)

Conclusion

Diabetic Charcot arthropathy yields marked risk of amputation and mortality. However, mortality frequencies were unexpectedly lesser compared to those related to the published frequencies associated with diabetic foot ulcers.

中文翻译：

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与糖尿病 Charcot 足关节病相关的截肢和死亡率频率：一项荟萃分析

背景

据报道，新发糖尿病性溃疡后的五年死亡率和截肢率分别高达 55% 和 74%。适用于下肢截肢患者。在Charcot 关节病之后，报告的这些频率变化很大。本荟萃分析的目的是对患有 Charcot 足关节病的糖尿病患者的截肢和死亡率频率进行定量评估。

方法

自成立以来至 2021 年 12 月，电子搜索策略应用于 Medline、Web of Science、Cochrane Library 和 Google Scholar。提取的数据包括研究设计、样本和患者特征、糖尿病类型和持续时间、实验室结果、诊断时的溃疡、合并症和随访期。荟萃分析报告随机效应值用于生成权重结果。

结果

定量荟萃分析共纳入 16 项研究，合并样本包括 2250 名患者和 2272 只夏科氏足。两项包括 255 名患者的研究得出的 1 年死亡率为 4%（95% CI = 0.018–0.065）。包括 1706 名患者在内的七项研究报告的 5 年死亡率为 24.5%（95% CI = 0.172–0.326，I² = 88.5%）。包括 277 名患者在内的四项研究得出的七年以上死亡率为 16%（95% CI = 0.065–0.289，I² = 84.3%）。包括 871 只脚在内的 10 项研究得出的截肢频率为 15%（95% CI = 0.067–0.258，I² = 93.6%），其中 9% 是大截肢（95% CI = 0.062–0.127，I² = 60%），5% 是轻微截肢（95% CI = 0.004–0.126，I² = 94.7%）

结论

糖尿病性 Charcot 关节病会产生显着的截肢和死亡风险。然而，与已发表的与糖尿病足溃疡相关的频率相比，死亡率频率出人意料地低。