Frailty Is a Risk Factor for Poor Diabetic Foot Ulcer Healing and Re-hospitalisation

Pavankumar Kamat


February 25, 2022


  • The prevalence of frailty was higher in patients hospitalised with diabetic foot ulcers (DFUs) and was associated with poor wound healing and re-hospitalisation events.

Why This Matters

  • A better understanding of frailty may help guide individualised care planning for patients with DFUs.

Study Design

  • A prospective cohort study included 76 patients with DFUs (type 1 diabetes, n = 8; type 2 diabetes, n = 68) admitted to St Thomas' Hospital, London.

  • Frailty status was evaluated 24 hours after admission using a frailty index (FI), frailty being FI>0.25.

  • Primary outcome: non-healing of DFUs at 6 months.

  • Secondary outcome: re-hospitalisation events for any cause within 6 months from the time of hospital discharge.

  • Funding: None disclosed.

Key Results

  • Of 76 patients, 54 (71%) were frail and 22 (29%) were non-frail.

  • At 6 months, the frail group had a significantly higher rate of poor DFU healing than the non-frail group (81.5% vs 55%; P=0.023).

  • The frail vs non-frail group also had a significantly higher rate of re-hospitalisation (90.3% vs 54%; P=0.001).

  • In multivariable analyses, the frail vs non-frail group demonstrated a significantly increased risk of (adjusted OR; 95% CI):

    • poor DFU healing (5.54; 1.28 to 23.91; P=0.02); and

    • re-hospitalisation events (17.52; 2.65 to 116; P=0.003).


  • Small sample size.

  • Frailty status was not evaluated at discharge.

Maltese G, Basile G, Meehan H, Fuller M, Cesari M, Fountoulakis N, Karalliedde J. Frailty Is Associated with Impaired Diabetic Foot Ulcer Healing and All-Cause Re-Hospitalization. J Nutr Health Aging. 2022;26(2):169-173. doi: 10.1007/s12603-022-1726-7. PMID: 35166310 View Full Text.


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