In blood we trust: anemia as a negative healing prognostic factor in diabetic foot patients.

Aim: Anemia has been associated with severity of diabetic foot (DF) disease. Our study aimed to evaluate whether the presence of anemia could decrease the healing chances in DF.

Methods: We retrospectively analyzed all patients admitted in our department in 2021 for DF, dividing them according to presence (Group A) or absence (Group B) of anemia. Groups were compared for clinical and demographic characteristics, procedures and outcomes: healing rate (HR) at 6 months, healing time (HT) and recurrence rate (RR) at 12 months.

Results: We sorted out data from 196 consecutive patients: 114 (58%) in Group A and 82 (42%) in B. Group A had a higher male prevalence and a longer duration of disease. Group A showed lower hemoglobin concentration (10.3 ± 1.3 g/dL vs 13.1 ± 1.4 g/dL, p < 0.002) and red blood cells count (3.4 ± 0.5 × 10/mL vs 4.8 ± 0.6 × 10/mL, p = 0.004). Group A presented a lower HR (55.2% vs 76.8%, p = 0.0028), no differences in HT and a higher RR (23.6% vs 17.1%, p < 0.02). Cox's logistic regression on healing confirmed the negative impact of anemia: hazard ratio 2.8 (CI 95% 1.4-5.4, p = 0.0037).

Conclusions: Anemia is frequent in DF and associates to a reduction in healing chances and an increase in recurrences representing an independent predictor of healing failure.