{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:11:23Z","timestamp":1787314283520,"version":"build-2736575974"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate impact of Social Determinants of Health (SDOH) on clinical evolution of Charcot neuro-osteoarthropathy (CNO) in people with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively collected SDOH for patients with acute CNO from 2022 to 2023: distance from hospital, education, employment status, family (number of cohabitants) and residential environment (urban, suburban and rural). We focused on SDOH impact on clinical outcomes: clinical and radiological stabilization time.<\/jats:p>\n                    <jats:p>We assessed association between these and SDOH using multiple linear regression and Kaplan-Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 62 patients with an acute episode of CNO. 64.5% were women, 27.4% had type 1 diabetes mellitus, at CNO-diagnosis mean age was 65.8 years and diabetes duration 18.7 years.<\/jats:p>\n                    <jats:p>Average distance from the clinic was 80.4\u2005km; 25% of patients lived in urban and 46.2% in rural areas. 46.2% were still working at diagnosis; 15.4% lived alone, 38.4% with one and 46.2% with more cohabitants.<\/jats:p>\n                    <jats:p>Stabilization times were significantly associated with urban residence while number of cohabitants predicted radiological stabilization only.<\/jats:p>\n                    <jats:p>Kaplan-Meier analysis showed that stabilization times were shorter for patients living in urban areas and with more cohabitant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SDOH impact clinical outcome in people with diabetes with CNO. Healthcare professionals should consider these factors to customize treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15347346261416588","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T17:38:25Z","timestamp":1769535505000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Social Determinants of Health on Clinical Outcomes in a Cohort of Acute Charcot Neuro-Osteoarthropathy Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7760-936X","authenticated-orcid":false,"given":"Francesco","family":"Giangreco","sequence":"first","affiliation":[{"name":"Pisa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9007-9378","authenticated-orcid":false,"given":"Elisabetta","family":"Iacopi","sequence":"additional","affiliation":[{"name":"Pisa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Goretti","sequence":"additional","affiliation":[{"name":"Pisa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Pieruzzi","sequence":"additional","affiliation":[{"name":"Pisa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8704-561X","authenticated-orcid":false,"given":"Alberto","family":"Piaggesi","sequence":"additional","affiliation":[{"name":"Pisa University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(23)00223-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.4662.1095"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4711-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-001549"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02107-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-024-03696-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-022-00586-9"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci17-0029"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0043"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(99)90012-0"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13679"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-016-1508-5"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-2590"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3653"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1695"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716673985"},{"key":"e_1_3_3_20_2","volume-title":"World report on social determinants of health equity","author":"WHO","year":"2025","unstructured":"WHO. World report on social determinants of health equity. WHO; 2025."},{"key":"e_1_3_3_21_2","unstructured":"(CDC) CfDCaP. Social Determinants of Health (SDOH). https:\/\/www.cdc.gov\/about\/priorities\/why-is-addressing-sdoh-important.html (2024 accessed 21 June 2025)."},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14784"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713517097"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0844"},{"key":"e_1_3_3_25_2","unstructured":"Frykberg R Sanders L. Diabetic neuropathic osteoarthropathy: the charcot foot. The high risk foot in diabetes mellitus 1991."},{"key":"e_1_3_3_26_2","unstructured":"(ISTAT) INdS. Demo: Demografia in cifre. https:\/\/demo.istat.it\/app\/?i=RCS&l=it (2024 accessed 21 June 2025)."},{"key":"e_1_3_3_27_2","unstructured":"Commission E (FAO) FaAOotUN (UNHabitat) UNHSP International Labour Organization (ILO) (OECD) OfEC-oaD Bank. TW. 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