{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T19:47:30Z","timestamp":1774727250326,"version":"3.50.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sicilian Health Department \u201cPSN Piede Diabetico\u201d","award":["37475"],"award-info":[{"award-number":["37475"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to analyze changes in the incidence, management and mortality of DFU in Sicilian Type 2 diabetic patients hospitalized between two eras, i.e. 2008\u20132013 and 2014\u20132019.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We compared the two eras, era1: 2008\u201313, era2: 2014\u201319. In era 1, n = 149, and in era 2, n = 181 patients were retrospectively enrolled.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>In the population hospitalized for DFU in 2008\u20132013, 59.1% of males and 40.9% of females died, whilst in 2014\u20132019 65.9% of males and 34.1% of females died. Moderate chronic kidney disease (CKD) was significantly higher in patients that had died than in ones that were alive (33% vs. 43%, p &lt; 0.001), just as CKD was severe (14.5% vs. 4%, p &lt; 0.001). Considering all together the risk factors associated with mortality, at Cox regression multivariate analysis only moderate-severe CKD (OR 1.61, 95% CI 1.07\u20132.42, p 0.021), age of onset greater than 69 years (OR 2.01, 95% CI 1.37\u20132.95, p &lt;0.001) and eGFR less than 92 ml\/min (OR 2.84, 95% CI 1.51\u20135.34, p 0.001) were independently associated with risk of death.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Patients with DFU have high mortality and reduced life expectancy. Age at onset of diabetic foot ulcer, eGFR values and CKD are the principal risk factors for mortality.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0259405","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T18:35:03Z","timestamp":1638902103000},"page":"e0259405","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diabetic foot ulcers: Retrospective comparative analysis from Sicily between two eras"],"prefix":"10.1371","volume":"16","author":[{"given":"Valentina","family":"Guarnotta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Radellini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrica","family":"Vigneri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achille","family":"Cernigliaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia","family":"Pant\u00f2","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Scondotto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero Luigi","family":"Almasio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Guercio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-9395","authenticated-orcid":true,"given":"Carla","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"pone.0259405.ref001","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic Foot Ulcers and Their Recurrence","volume":"376","author":"DG Armstrong","year":"2017","journal-title":"N Engl J Med"},{"issue":"Suppl 1","key":"pone.0259405.ref002","doi-asserted-by":"crossref","first-page":"e3249","DOI":"10.1002\/dmrr.3249","article-title":"Diabetic foot disease: \u201cThe Times They are A Changin\u201d.","volume":"1","author":"SA Bus","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"pone.0259405.ref003","doi-asserted-by":"crossref","first-page":"7631659","DOI":"10.1155\/2018\/7631659","article-title":"Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)-Two-Year Follow-Up Study.","volume":"2018","author":"L Yazdanpanah","year":"2018","journal-title":"Int J Endocrinol"},{"issue":"Suppl 1","key":"pone.0259405.ref004","doi-asserted-by":"crossref","first-page":"S124","DOI":"10.2337\/dc19-S011","article-title":"Microvascular complications and foot care: standards of medical care in diabetes\u20142019.","volume":"42","author":"American Diabetes Association","year":"2019","journal-title":"Diabetes Care"},{"issue":"Suppl 1","key":"pone.0259405.ref005","first-page":"e3273","article-title":"Guidelines on the classification of diabetic foot ulcers (IWGDF 2019).","volume":"36","author":"International Working Group on the Diabetic Foot (IWGDF).","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"issue":"Suppl 1","key":"pone.0259405.ref006","doi-asserted-by":"crossref","first-page":"e3269","DOI":"10.1002\/dmrr.3269","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). 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