Background: Charcot neuropathic osteoarthropathy (CN) is an uncommon but potentially serious complication of diabetes mellitus (DM). Aspects of morbidity and mortality in CN patients have not been fully described. The aim of this study was to evaluate the impact of QTc prolongation on long-term mortality in people with DM and CN.
Methods: All patients diagnosed with acute CN at a tertiary hospital based Diabetic Foot Unit between 2003 and 2017 were retrospectively studied. QTc prolongation was defined as ≥440 ms and confirmed with manual measurement. Patients with QTc-prolonging drugs and pacemakers were excluded. Data are given as median (IQR). Log Rank tests were used for survival analysis. A Cox regression model was performed for 10-year mortality, using age, DM duration, QTc interval, HbA1c and creatinine as continuous variables, and hypertension, ischemic heart disease, cerebrovascular disease, smoking history and proliferative retinopathy as categorical variables.
Results: In all, 81 patients (age 62 [52.5-68] years, 44% females, 38% type 1 DM, DCCT 7.5% [6.8-8.6%]) were included. QTc prolongation was associated with significantly higher mortality (Figure 1). In the Cox regression model, only age (HR 1.08, p<0.05) and QTc interval (HR 1.03, p<0.05) remained significant factors.
J. Schoug: None. K. Fagher: Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. M. Londahl: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi.
