Presentation Abstract

Session: The Burden of Diabetic Foot Disease (With Roger Pecoraro Award Lecture)
Abstract Number: 117-OR
Title: Charcot Neuroarthropathy and Self-Reported Outcome
Presentation Start: 6/22/2013 4:45:00 PM
Presentation End: 6/22/2013 5:00:00 PM
Abstract: Charcot neuroarthropathy is associated with premature mortality, increased risks of foot ulcer, infection and lower extremity amputation. Previous reports have demonstrated reduced quality of life in CN patients using the SF 36 as a generic measure of quality of life. The aim of this study was to assess self-reported quality of life using a lower extremity region specific assessment, hypothesizing that diabetic patients with CN would have a lower region specific self-reported score than diabetic patients without foot pathology. Region specific quality of life was recorded with the Foot and Ankle Ability Measure (FAAM), an instrument that has been found to reliable, valid and reproducible in patients with diabetic related foot pathology. The control group of diabetic patients without foot pathology was assessed during routine foot screenings of diabetic patients without any complaints referable to their foot. For results see Table 1.
Diabetic CN (N=50)Control (N=56)P value
Age (Mean ± SD)56.3± 9.858.2± 11.6P =0.37
Males:Females Number29:2133:23P = 1.00
Type 1:Type 2 Diabetes
12:383:53P =0.01
Insulin Use Number(%)33( 66%)21( 37.5%)P =0.06
Duration of DM years± SD17.7 ± 11.89.7 ± 8.1P <0.0001
Neuropathy Number(%)50(100%)21( 37.5%)P < 0.0001
Foot Ankle Abilty Measure (FAAM)
FAAM General/ADL
Maximum Score 84
38.4± 20.670.2 ± 15.7P <0.0001
% (General-ADL Score/84 times 100)45.7 ± 24.583.6 ± 18.3P <0.0001
FAAM Sports
Maximum Score 32
7.3 ± 7.420.5± 9.9P <0.0001
% (Sports Score/32 times 100)22.8 ± 23.265.1 ± 30.9P <0.0001

General measures of quality of life such as the SF 36 are useful, but region specific outcome measures such as the FAAM may be more appropriate when assessing the outcomes of treatment as it pertains to foot and ankle pathology. The results of this study demonstrate that patients with CN report mean region specific ADL scores that are two standard deviations below a group of diabetic patients without foot complaints. Our two groups were similar with to age and gender, although patients with CN were more likely to be neuropathic, more likely to have Type 1 DM and longer duration of disease.

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