Abstract
Diabetic foot infections (DFI) are an increasingly common cause of hospitalizations.
Once hospitalized with DFI, many patients require some level of amputation, often
undergoing multiple operations. With increasing importance on patient-centered metrics,
self-reported health-related quality of life (HRQOL) tools have been developed. This
prospective cohort study aimed assessed the impact of DFI on HRQOL. Two hundred twenty-four
patients completed the 29-item Patient-Reported Outcome Measurement Information System
(PROMIS) and 12-Item Short Form (SF-12) survey. Secondary outcomes using the Foot
and Ankle Ability Measures survey were obtained and included in the analysis. The
study group was comprised of hospitalized patients with DFIs (n = 120), and the control
group was comprised of patients with diabetes who were evaluated for routine outpatient
foot care (n = 104); diabetic foot screening, wound care, onychomycosis, and/or callosities.
Using this cohort, a propensity score-matched sample of hospitalized patients with
DFI (n = 35) and control group patients (n = 35) was created for comparative analysis.
The 2-independent sample t test was used to test for group differences on each of the PROMIS subscale outcomes.
Using PROMIS, we found that hospitalized patients with DFI reported significantly
worse HRQOL in 6 of 7 subscales (physical function, anxiety, depression, fatigue,
social role, pain intensity; p value range: .0001-.02) compared to outpatients with diabetes evaluated for routine
foot care. There was no significant difference between the 2 groups on sleep disturbance
(p = .22). Patients hospitalized for DFI report lower HRQOL compared to patients with
diabetes receiving routine outpatient foot care.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: July 22, 2021
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: Author Wukich discloses a consultancy and advisory role with Orthofix and Wright Medical, and he receives royalties from Arthrex. Author Raspovic discloses a consultancy and advisory role with Orthofix. Authors La Fontaine, Liu, and Raspovic serve as an editor for The Journal of Foot & Ankle Surgery.
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© 2021 by the American College of Foot and Ankle Surgeons. All rights reserved.
