Emergency Hospitalization, Amputation, and Survival After Charcot Neuro-Osteoarthropathy Diagnosis in People With Diabetes: A Regional Registry-Based Cohort Study.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42520058.
- Also identified by DOI 10.2337/dc26-0373.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
The aim for this study was to describe adverse outcomes after Charcot neuro-osteoarthropathy (CNO) diagnosis in adults with diabetes and examine variation by clinical and sociodemographic characteristics. A regional, registry-based cohort study was conducted using linked routinely collected health care data from adults with diabetes and a first recorded CNO diagnosis in the National Health Service Greater Glasgow and Clyde, Scotland (2015-2024). Outcomes were all-cause emergency hospitalization, lower-extremity amputation, all-cause mortality, and amputation-free survival. Time-to-event methods and multivariable regression were used to estimate event probabilities and tested associations with clinical characteristics. From 127,513 adults with diabetes, 140 individuals with a first recorded CNO diagnosis were identified; their mean age was 59 years, and 67% were men. During a median 4.6-year follow-up, 123 patients (87.9%) had an emergency admission, 44 (31.4%) underwent lower-extremity amputation (minor or major), and 53 (37.9%) died. The estimated 5-year survival was 67%, while 5-year amputation-free survival was 44% (median 4.04 years). Advanced chronic kidney disease (stages 4 and 5) was associated with higher risk across outcomes. High or active foot-risk status was independently associated with lower-extremity amputation (subdistribution hazard ratio 8.52; 95% CI 2.05-35.45) and shorter amputation-free survival (hazard ratio (HR) 2.09; 95% CI 1.15-3.80), and older age was independently associated with higher mortality rate (HR 3.04; 95% CI 1.50-6.16). Adverse outcomes in CNO were frequent and occurred early after diagnosis, with high rates of emergency hospitalization, amputation, and death. These findings support CNO as a marker of systemic vulnerability and highlight the need for prioritized surveillance and multidisciplinary management in routine clinical care.