{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T09:25:55Z","timestamp":1782638755517,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An increasing prevalence of diabetes mellitus has led to a high risk of diabetic foot infections (DFI) and associated morbidity. However, little is known about the relationship between DFI and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the risk of mortality and associated factors in patients with DFI in an Australian context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study of inpatients with DFI between May 2012 and October 2016 was done at Royal Darwin Hospital, a tertiary referral hospital for the Top End of the Northern Territory. Primary outcome was 1\u2010year mortality with Cox regression analysis undertaken to assess risk factors for mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and thirteen consecutive adult diabetic patients with 737 admissions were referred to the High\u2010Risk Foot Service for DFI. Cumulative risk of mortality at 1 year was 8.9% (95% confidence interval (CI) 6.4\u201312.2). On univariable analysis, mortality was associated with older age (hazard ratio (HR) per year increase 1.08, 95% CI 1.06\u20131.11, <jats:italic>P<\/jats:italic> = 0.001), haemodialysis (HR 3.64, 1.74\u20137.62, <jats:italic>P<\/jats:italic> &lt; 0.001), isolation of <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (HR 2.32, 1.05\u20135.12, <jats:italic>P<\/jats:italic> = 0.04) and ischaemic heart disease (HR 2.05, 1.04\u20134.07, <jats:italic>P<\/jats:italic> = 0.04), while indigenous status (HR 0.48, 0.25\u20130.95, <jats:italic>P<\/jats:italic> = 0.04) and HbA1c &gt; 7% (HR 0.45, 0.20\u20130.99, <jats:italic>P<\/jats:italic> &lt; 0.05) were protective. After adjusting for confounders, independent risk factors for mortality were haemodialysis (adjusted HR 5.76, 95% CI 2.28\u201314.59, <jats:italic>P<\/jats:italic> &lt; 0.001) and older age (adjusted HR 1.09, 1.06\u20131.13, <jats:italic>P<\/jats:italic> &lt; 0.001). Patients on haemodialysis had a cumulative risk of mortality of 24.5% (95% CI 14.0\u201340.8) at 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a high risk of mortality associated with DFI, substantially increased in patients undergoing haemodialysis, highlighting the importance of early and dedicated interventions targeted at this high\u2010risk group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14184","type":"journal-article","created":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T06:58:17Z","timestamp":1543993097000},"page":"867-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Risk factors for mortality in patients with diabetic foot infections: a prospective cohort study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6496-5280","authenticated-orcid":false,"given":"Sarah A.","family":"Lynar","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire H.","family":"Robinson","sequence":"additional","affiliation":[{"name":"High\u2010Risk Foot Service Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S.","family":"Boutlis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Department of Infectious Diseases Canberra Hospital  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Commons","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Global Health Division, Menzies School of Health Research Charles Darwin University  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2009.10.007"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2009.00450.x"},{"key":"e_1_2_7_4_1","volume-title":"Burden of Lower Limb Amputations Due to Diabetes in Australia: Australian Burden of Disease Study 2011","author":"Australian Institute of Health and Welfare (AIHW)","year":"2017"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1146-5-12"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2007.00228.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177916"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.09.016"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.04.011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199611)13:11<967::AID-DIA266>3.0.CO;2-K"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0295"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7547\/1030002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2699"},{"key":"e_1_2_7_14_1","unstructured":"Older people overview: Australian Institute of Health and Welfare (AIHW) (Internet); 2018 [cited 2018 Nov 16]. Available from URL:https:\/\/www.aihw.gov.au\/reports-statistics\/population-groups\/older-people\/overview"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2.491"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.7547\/0980489"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13537"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.11.020"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00664"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.krcp.2013.10.001"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12249"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2015.09.004"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-010-1672-5"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.04.010"},{"key":"e_1_2_7_26_1","first-page":"288","article-title":"Infection of foot ulcers with Staphylococcus aureus associated with increased mortality in diabetic patients","volume":"3","author":"Mantey I","year":"2000","journal-title":"Commun Dis Public Health"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.14184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T22:10:47Z","timestamp":1694297447000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1111\/imj.14184"],"URL":"https:\/\/doi.org\/10.1111\/imj.14184","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2018-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}