ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicInflammation and Diabetes: Unraveling Vascular Complications and Therapeutic InnovationsView all 7 articles
Mortality Predictors and Survival Nomogram for Hospitalized Diabetic Foot Patients: A Decade-Long Cohort
Provisionally accepted
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
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Objectives: To evaluate mortality and risk factors in moderate-to-severe diabetic foot ulcer (DFU) hospitalized patients and develop a prognostic tool. Methods: This cohort study enrolled 485 eligible DFU patients (2009-2014), followed through 2024. Mortality was analyzed using Cox regression and Kaplan-Meier methods, focusing on peripheral artery disease (PAD) and other risk factors (p<0.05). A nomogram predicting 3-year mortality was developed based on multivariate Cox analysis. Results: The 3-year all-cause mortality rate in this cohort of 485 diabetic foot ulcer patients was 49.3%. The two most salient predictors of mortality were renal impairment and PAD severity. Patients requiring dialysis had a 3.05-fold increased risk of death, while the risk escalated sharply with PAD severity, reaching a 3.57-fold increase for severe PAD. The prognostic nomogram, which integrated these key factors, demonstrated strong predictive accuracy for 3-year survival, with a C-index of 0.79 and a 3-year AUC of 0.87. Conclusions: Hospitalized patients with moderate-to-severe diabetic foot show high mortality, predominantly associated with dialysis, CKD, and PAD. The developed nomogram effectively predicts 3-year mortality risk.
Keywords: Diabetic foot ulcer, Mortality rate, Kaplan-Meier analysis, Prediction model, risk factor
Received: 19 Aug 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Li, Shi, Gu, Cai, Gu, Yang, TANG and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Weiqing Wang
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