Journal of Diabetes Research

Research Article

Adherence to General Diabetes and Foot Care Processes, with Prompt Referral, Are Associated with Amputation-Free Survival in People with Type 2 Diabetes and Foot Ulcers: A Scottish National Registry Analysis

Table 1

Frequencies and univariate hazard ratios for major LEA as outcome in people with type 2 diabetes and DFU in Scotland.


Variable	Category	All ages				≤70				>70
Variable	Category	No LEA	LEA	Univariate HR (95% CI)		No LEA	LEA	Univariate HR (95% CI)		No LEA	LEA	Univariate HR (95%CI)

Age	Continuous	68.31 (12.74)	64.44 (12)	0.98 (0.97-0.99)	<0.01	58.07 (8.78)	57.68 (8.07)	1.00 (0.98-1.02)	0.786	78.81 (5.64)	77.75 (5.61)	0.98 (0.93-1.02)	0.288

Gender	Female (R.C.)	2556 (38.5)	46 (23.1)	1.00 (-)		1064 (31.6)	33 (25.0)	1.00 (-)		1492 (45.5)	13 (19.4)	1.00 (-)
Gender	Male	4090 (61.5)	153 (76.9)	2.06 (1.48-2.86)	<0.001	2300 (68.4)	99 (75.0)	1.38 (0.93-2.05)	0.099	1790 (54.5)	54 (80.6)	3.57 (1.95-6.54)	<0.001

SIMD score	≥4 (R.C.)	3728 (56.1)	101 (50.8)	1.00 (-)		1713 (50.9)	58 (43.9)	1.00 (-)		2015 (61.4)	43 (64.2)	1.00 (-)
	<3	2628 (39.5)	88 (44.2)	1.26 (0.94-1.67)	0.118	1498 (44.5)	70 (53.0)	1.43 (1.01-2.03)	0.043	1130 (34.4)	18 (26.9)	0.77 (0.44-1.34)	0.344
	Missing	290 (4.4)	10 (5.0)	1.24 (0.65-2.37)	0.534	153 (4.5)	4 (3.0)	0.74 (0.27-2.04)	0.544	137 (4.2)	6 (9.0)	2.04 (0.87-4.79)	0.135

Smoker	Past/never (R.C.)	5580 (84.0)	155 (77.9)	1.00 (-)		2625 (78.0)	94 (71.2)	1.00 (-)		2955 (90.0)	61 (91.0)	1.00 (-)
Smoker	Current	1066 (16.0)	44 (22.1)	1.53 (1.09-2.14)	0.017	739 (22.0)	38 (28.8)	1.53 (1.05-2.23)	0.033	327 (10.0)	6 (9.0)	0.95 (0.41-2.19)	0.899

BMI	≥25 (R.C.)	1133 (17.0)	28 (14.1)	1.00 (-)		353 (10.5)	20 (15.2)	1.00 (-)		780 (23.8)	8 (11.9)	1.00 (-)
	<25	5144 (77.4)	160 (80.4)	1.18 (0.79-1.76)	0.416	2766 (82.2)	106 (80.3)	0.71 (0.44-1.14)	0.175	2378 (72.5)	54 (80.6)	2.03 (0.97-4.26)	0.042
	Missing	369 (5.6)	11 (5.5)	1.13 (0.56-2.26)	0.742	245 (7.3)	6 (4.5)	0.44 (0.18-1.10)	0.061	124 (3.8)	5 (7.5)	4.04 (1.32-12.39)	0.024

eGFR	>59 (R.C.)	3979 (59.9)	132 (66.3)	1.00 (-)		2446 (72.7)	97 (73.5)	1.00 (-)		1533 (46.7)	35 (52.2)	1.00 (-)
	≤59	2003 (30.1)	58 (29.1)	0.99 (0.73-1.35)	0.945	551 (16.4)	29 (22.0)	1.42 (0.94-2.15)	0.109	1452 (44.2)	29 (43.3)	0.96 (0.59-1.57)	0.874
	Missing	664 (10.0)	9 (4.5)	0.41 (0.21-0.80)	<0.01	367 (10.9)	6 (4.5)	0.40 (0.17-0.90)	0.011	297 (9.0)	3 (4.5)	0.45 (0.14-1.47)	0.138

Total cholesterol	≤5 mmol (R.C.)	5093 (76.6)	130 (65.3)	1.00 (-)		2373 (70.5)	77 (58.3)	1.00 (-)		2720 (82.9)	53 (79.1)	1.00 (-)
	>5 mmol	1507 (22.7)	69 (34.7)	1.80 (1.34-2.40)	<0.001	968 (28.8)	55 (41.7)	1.78 (1.26-2.52)	<0.01	539 (16.4)	14 (20.9)	1.39 (0.77-2.51)	0.286
	Missing	46 (0.7)	0 (0.0)	0.00 (0.00-Inf)	0.168	23 (0.7)	0 (0.0)	0.00 (0.00-Inf)	0.283	23 (0.7)	0 (0.0)	0.00 (0.00-Inf)	0.384

Peripheral vasc. disease	No (R.C.)	5968 (89.8)	132 (66.3)	1.00 (-)		3039 (90.3)	89 (67.4)	1.00 (-)		2929 (89.2)	43 (64.2)	1.00 (-)
Peripheral vasc. disease	Yes	678 (10.2)	67 (33.7)	4.05 (3.02-5.43)	<0.001	325 (9.7)	43 (32.6)	4.16 (2.89-5.98)	<0.001	353 (10.8)	24 (35.8)	4.12 (2.50-6.78)	<0.001

Claudication	No	5843 (87.9)	176 (88.4)	1.00 (-)		2938 (87.3)	116 (87.9)	1.00 (-)		2905 (88.5)	60 (89.6)	1.00 (-)
	Yes	291 (4.4)	17 (8.5)	2.00 (1.22-3.30)	0.013	156 (4.6)	12 (9.1)	2.09 (1.15-3.79)	0.028	135 (4.1)	5 (7.5)	1.76 (0.71-4.38)	0.262
	Missing	512 (7.7)	6 (3.0)	0.41 (0.18-0.92)	0.013	270 (8.0)	4 (3.0)	0.39 (0.14-1.05)	0.03	242 (7.4)	2 (3.0)	0.43 (0.10-1.74)	0.172

AMI	No (R.C.)	5925 (89.2)	154 (77.4)	1.00 (-)		3028 (90.0)	100 (75.8)	1.00 (-)		2897 (88.3)	54 (80.6)	1.00 (-)
AMI	Yes	721 (10.8)	45 (22.6)	2.49 (1.79-3.48)	<0.001	336 (10.0)	32 (24.2)	2.88 (1.93-4.29)	<0.001	385 (11.7)	13 (19.4)	1.92 (1.05-3.52)	0.049

CVD	No (R.C.)	6099 (91.8)	174 (87.4)	1.00 (-)		3145 (93.5)	113 (85.6)	1.00 (-)		2954 (90.0)	61 (91.0)	1.00 (-)
CVD	Yes	547 (8.2)	25 (12.6)	1.68 (1.11-2.56)	0.023	219 (6.5)	19 (14.4)	2.55 (1.57-4.15)	<0.001	328 (10.0)	6 (9.0)	0.91 (0.39-2.10)	0.815

Hypertension treatment	No (R.C.)	1828 (27.5)	42 (21.1)	1.00 (-)		970 (28.8)	28 (21.2)	1.00 (-)		858 (26.1)	14 (20.9)	1.00 (-)
	Yes	4747 (71.4)	157 (78.9)	1.47 (1.05-2.07)	0.021	2345 (69.7)	104 (78.8)	1.50 (0.99-2.27)	0.049	2402 (73.2)	53 (79.1)	1.44 (0.80-2.59)	0.214
	Missing	71 (1.1)	0 (0.0)	0.00 (0.00-Inf)	0.097	49 (1.5)	0 (0.0)	0.00 (0.00-Inf)	0.124	22 (0.7)	0 (0.0)	0.00 (0.00-Inf)	0.436

Retinopathy	No (R.C.)	3737 (56.2)	84 (42.2)	1.00 (-)		1661 (49.4)	53 (40.2)	1.00 (-)		2076 (63.3)	31 (46.3)	1.00 (-)
	Yes	2729 (41.1)	111 (55.8)	1.73 (1.30-2.29)	<0.001	1603 (47.7)	76 (57.6)	1.43 (1.01-2.03)	0.044	1126 (34.3)	35 (52.2)	2.05 (1.26-3.32)	<0.01
	Missing	180 (2.7)	4 (2.0)	1.15 (0.42-3.13)	0.791	100 (3.0)	3 (2.3)	1.07 (0.33-3.41)	0.914	80 (2.4)	1 (1.5)	1.02 (0.14-7.50)	0.982

Nine care processes before DFU	<9 (R.C.)	2957 (44.5)	88 (44.2)	1.00 (-)		1451 (43.1)	63 (47.7)	1.00 (-)		1506 (45.9)	25 (37.3)	1.00 (-)
Nine care processes before DFU	9	3689 (55.5)	111 (55.8)	0.82 (0.62-1.09)	0.169	1913 (56.9)	69 (52.3)	0.72 (0.51-1.01)	0.056	1776 (54.1)	42 (62.7)	1.10 (0.67-1.81)	0.699

Foot care visits before DFU	No (R.C.)	4964 (74.7)	148 (74.4)	1.00 (-)		2493 (74.1)	92 (69.7)	1.00 (-)		2471 (75.3)	56 (83.6)	1.00 (-)
Foot care visits before DFU	Yes	1682 (25.3)	51 (25.6)	1.02 (0.74-1.40)	0.918	871 (25.9)	40 (30.3)	1.29 (0.89-1.87)	0.184	811 (24.7)	11 (16.4)	0.58 (0.30-1.11)	0.079

wks	≤12 wks (R.C.)	5064 (76.2)	177 (88.9)	1.00 (-)		2583 (76.8)	117 (88.6)	1.00 (-)		2481 (75.6)	60 (89.6)	1.00 (-)
wks	>12wks	1582 (23.8)	22 (11.1)	0.42 (0.27-0.66)	<0.001	781 (23.2)	15 (11.4)	0.44 (0.26-0.76)	<0.01	801 (24.4)	7 (10.4)	0.38 (0.18-0.84)	<0.01

Foot care quality after DFU	Low	3008 (45.3)	38 (19.1)	1.00 (-)		1508 (44.8)	24 (18.2)	1.00 (-)		1500 (45.7)	14 (20.9)	1.00 (-)
Foot care quality after DFU	High	3638 (54.7)	161 (80.9)	4.74 (3.33-6.77)	<0.001	1856 (55.2)	108 (81.8)	4.71 (3.02-7.34)	<0.001	1782 (54.3)	53 (79.1)	4.53 (2.51-8.20)	<0.001

Foot care checks after DFU	No (R.C.)	1307 (19.7)	16 (8.0)	1.00 (-)		667 (19.8)	9 (6.8)	1.00 (-)		640 (19.5)	7 (10.4)	1.00 (-)
Foot care checks after DFU	Yes	5339 (80.3)	183 (92.0)	4.40 (2.64-7.35)	<0.001	2697 (80.2)	123 (93.2)	5.08 (2.58-10.01)	<0.001	2642 (80.5)	60 (89.6)	3.38 (1.54-7.43)	<0.001

CV visits after DFU	0 (R.C.)	4296 (64.6)	101 (50.8)	1.00 (-)		1858 (55.2)	62 (47.0)	1.00 (-)		2438 (74.3)	39 (58.2)	1.00 (-)
CV visits after DFU	≥1	2350 (35.4)	98 (49.2)	1.67 (1.27-2.21)	<0.001	1506 (44.8)	70 (53.0)	1.35 (0.96-1.89)	0.088	844 (25.7)	28 (41.8)	2.02 (1.24-3.28)	<0.01

CV care quality after DFU	Low (R.C.)	5688 (85.6)	156 (78.4)	1.00 (-)		2709 (80.5)	106 (80.3)	1.00 (-)		2979 (90.8)	50 (74.6)	1.00 (-)
CV care quality after DFU	High	958 (14.4)	43 (21.6)	1.63 (1.16-2.28)	<0.01	655 (19.5)	26 (19.7)	1.05 (0.68-1.61)	0.825	303 (9.2)	17 (25.4)	3.32 (1.92-5.77)	<0.001

Minor LEA	No (R.C.)	6371 (95.9)	154 (77.4)	1.00 (-)		3180 (94.5)	97 (73.5)	1.00 (-)		3191 (97.2)	57 (85.1)	1.00 (-)
Minor LEA	Yes	275 (4.1)	45 (22.6)	4.68 (3.35-6.53)	<0.001	184 (5.5)	35 (26.5)	4.44 (3.01-6.54)	<0.001	91 (2.8)	10 (14.9)	4.33 (2.21-8.50)	<0.001