To evaluate impact of Social Determinants of Health (SDOH) on clinical evolution of Charcot neuro-osteoarthropathy (CNO) in people with diabetes.
Methods
We retrospectively collected SDOH for patients with acute CNO from 2022 to 2023: distance from hospital, education, employment status, family (number of cohabitants) and residential environment (urban, suburban and rural). We focused on SDOH impact on clinical outcomes: clinical and radiological stabilization time.
We assessed association between these and SDOH using multiple linear regression and Kaplan-Meier analysis.
Results
We analyzed 62 patients with an acute episode of CNO. 64.5% were women, 27.4% had type 1 diabetes mellitus, at CNO-diagnosis mean age was 65.8 years and diabetes duration 18.7 years.
Average distance from the clinic was 80.4 km; 25% of patients lived in urban and 46.2% in rural areas. 46.2% were still working at diagnosis; 15.4% lived alone, 38.4% with one and 46.2% with more cohabitants.
Stabilization times were significantly associated with urban residence while number of cohabitants predicted radiological stabilization only.
Kaplan-Meier analysis showed that stabilization times were shorter for patients living in urban areas and with more cohabitant.
Conclusions
SDOH impact clinical outcome in people with diabetes with CNO. Healthcare professionals should consider these factors to customize treatment.
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