P-449: Association of biochemical and clinical parameters at ulcer healing with risk of recurrence in diabetic foot patients: a retrospective cohort study in Karachi
A Naz, M Atif, S Askari, F Abbasi, A HatimAbstract
Introduction
Diabetic foot ulcers (DFUs) are a major complication of diabetes with high recurrence rates, contributing to substantial morbidity and healthcare burden. Evidence on predictors of recurrence at the time of ulcer healing is limited in Pakistan.
Objectives
To assess the association between biochemical and clinical parameters at ulcer healing and the risk of DFU recurrence, and to estimate recurrence proportion in a tertiary care setting.
Methods
A retrospective cohort study will be conducted at Baqai Institute of Diabetology & Endocrinology, Karachi. Adult patients (≥18 years) with healed DFUs between January 2023 and September 2025 will be included and followed until March 2026. Biochemical parameters (HbA1c, hemoglobin, triglycerides, HDL, LDL) and clinical parameters (peripheral arterial disease, ankle-brachial index, neuropathy, ulcer site) will be assessed at healing. The primary outcome is time to recurrence. Cox proportional hazards regression will be used to estimate adjusted hazard ratios controlling for age, gender, and diabetes duration.
Results
Approximately 100–150 patients are expected to be included. Based on existing literature, recurrence is anticipated in approximately 25–35% of patients during follow-up. Key risk factors such as poor glycemic control, dyslipidemia, anemia, peripheral arterial disease, neuropathy, and plantar ulcer location are expected to show positive associations with recurrence.
Conclusions
This study will provide local evidence on predictors of DFU recurrence. Identifying high-risk patients at the time of healing may support targeted follow-up strategies to reduce recurrence in resource-limited settings.