Risk factors for plantar foot ulcer recurrence in patients with diabetes - A prospective pilot study

Introduction: Diabetic foot ulcer (DFU) is a complication of diabetes mellitus (DM) with established recurrence risk factors evaluating patients from United States or Europe. There are scarce studies in developing countries about these risks. The aim of this study was to evaluate risk factors associated with DFU recurrence in a Brazilian prospective cohort. Materials and methods: A prospective cohort of patients with healed DFU followed from January 2014 to June 2017 in Curitiba, Brazil. Periodic home visits from a specialist nurse in DFU were performed during the period of the study to evaluate recurrence of ulcer. The presence of risk factors in the group of patients that developed an ulcer in the follow-up period was compared with the presence of these factors in the group of patients without recurrence. At enrollment, 35 subjects presented a previous ulcer distal with complete healing to follow-up. Results: From 35 patients, 15 were male (43%) and the mean age was of 65.8 +/- 10.9 years (48-85 year). Most patients were married with a low income ( < US$ 250/month). The mean BMI was 26.5 +/- 5.6 kg/cm(2) . Seventy-four percent (26/35) had another comorbidity. The mean duration of DM until ulcer was 14.6 +/- 5.2 years. The global mortality during the study (3 years) was 14%. The DFU recurred in 23 patients (65.7%). Both groups had similar findings, except by lower income ( < US$ 250/month) in the group of recurrent DFU. Conclusion: Recurrence of DFU is frequent and associated with low familiar income in a pilot Brazilian study.