A Systematic Review Examining the Association of Falls With Diabetes-Related Foot Ulcers.

IF 2.5 3区医学 Q1 ORTHOPEDICS

Journal of Foot and Ankle Research Pub Date : 2025-06-01 DOI:10.1002/jfa2.70057

Mike Wu, Mallika Sinha, Chanika Alahakoon, Kristen S Barratt, Shivshankar Thanigaimani, Jonathan Golledge

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Abstract

Background: The aim of this study was to systematically review the risk of falls in people with diabetes-related foot ulcers (DFU).

Methods: A systematic search of Medline, Pubmed, Embase, Cochrane and CINAHL was undertaken to identify observational studies reporting falls and containing a group of people with a DFU and a control group with diabetes but no DFU. Risk of bias was assessed by a modified Newcastle-Ottawa Scale. Meta-analysis was performed using a random effects model.

Results: Four studies involving 3643 participants with a DFU and 42,436 participants with diabetes but no DFU were included. A meta-analysis showed high heterogeneity between studies (I² = 95%) and an increased risk of falls in people with DFU (risk ratio 2.25 and 95% CI 1.05-4.84). One study had a low risk of bias and three studies had a high risk of bias. Leave-one-out analyses showed that exclusion of the study with the largest effect on heterogeneity resulted in a risk ratio of 1.80 (95% CI 1.33-2.43 and I² = 0%).

Conclusions: Currently available evidence suggests people with a DFU have a higher risk of falls but most past studies have a high risk of bias. Further well-designed cohort studies are required.

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一项检查跌倒与糖尿病相关足溃疡关系的系统综述。

背景：本研究的目的是系统地回顾糖尿病相关性足溃疡（DFU）患者跌倒的风险。方法：对Medline、Pubmed、Embase、Cochrane和CINAHL进行系统检索，以确定报告跌倒的观察性研究，其中包括一组患有DFU的患者和一组患有糖尿病但没有DFU的对照组。偏倚风险采用改良的纽卡斯尔-渥太华量表进行评估。采用随机效应模型进行meta分析。结果：四项研究包括3643名DFU患者和42436名无DFU的糖尿病患者。一项荟萃分析显示，研究之间存在高度异质性（I2 = 95%）， DFU患者跌倒风险增加（风险比2.25,95% CI 1.05-4.84）。一项研究有低偏倚风险，三项研究有高偏倚风险。留一分析显示，排除对异质性影响最大的研究导致风险比为1.80 （95% CI 1.33-2.43, I2 = 0%）。结论：目前可获得的证据表明，患有DFU的人有更高的跌倒风险，但大多数过去的研究都有很高的偏倚风险。需要进一步精心设计的队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.