Background: Diabetes mellitus (DM) is considered a frequent metabolic disorder and its prevalence in adults has been increasing in the last years. Charcot neuroarthropathy is considered a main etiology of morbidity among diabetic cases with subsequent joint destruction, which ends ultimately in deformity. The mortality in cases with Charcot foot was more than expected. However, there were no differences among cases with Charcot and cases with uncomplicated neuropathic ulcers.
Objective: This study aimed to investigate the mortality rate in patients with Charcot's foot.
Material and methods: A PubMed search was done with the key words “Charcot foot, Diabetes, Mortality, CKD, IHD" We could trace about 1000 papers on the subject. Electronic database was systematically searched for literature discussing the Epidemiology, Pathogenesis, Clinical features, and Investigations, Management and Prognosis of Charcot neuroarthropathy. We applied no restrictions on publication date. Article eligibility was assessed independently by all authors. Reasons for exclusion of articles based on title or abstract were (1) nonoriginal data (e.g., editorials, guidelines, and comments), (2) nonclinical articles (e.g., technical or animal studies), (3) case reports, and (4) articles not written in English language. All authors independently chose the most relevant papers with regard to target topics resulting in the identification of 25 “most pertinent" articles.
Results: Diabetic cases with Charcot foot were more susceptible for mortality compared to Charcot foot free ones. The actual mechanism of such association was unknown, however it could be explained by the fact that cases with foot ulcers were at a high possibility for PVD and macrovascular diseases development compared to cases with CA with a subsequent higher mortality rates. Another possible mechanism is the existence of ulceration which raises the possibility of infections, with a subsequent increase in the possibility of complications which may ultimately end in death
Conclusion: Physicians should take into consideration, ACN in all cases complaining from warm red joint together with neuropathy. The backbone of diagnosis is still clinical however MRI and isotope bone scanning could be considered also as early diagnostic modalities. Very early management could possibly prevent limb-threatening deformity so encourage investigations and management is of great importance.