Academic Journal
Ethnic disparities in mortality following hospitalization for diabetic foot ulcer.
| Τίτλος: | Ethnic disparities in mortality following hospitalization for diabetic foot ulcer. |
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| Συγγραφείς: | Hamtzany O; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel., Sigawi T; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel., Kenig A; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Peled S; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Military Medicine and 'Tzameret', Medical Corps, Israel Defence Forces, Jerusalem, Israel., Leibovitch M; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Military Medicine and 'Tzameret', Medical Corps, Israel Defence Forces, Jerusalem, Israel., Olshtain-Pops K; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Division of Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Lorber J; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Vascular Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Tal N; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel., Hershkowitz I; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel., Tsur A; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Endocrinology and Metabolism, Clalit Health Services, Jerusalem, Israel., Haze A; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Diabetic Foot Unit, Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Gellman YN; The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Diabetic Foot Unit, Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Cahn A; Internal Medicine Section, Hadassah-Hebrew University Hospital, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Israel. Electronic address: avivit@hadassah.org.il. |
| Πηγή: | Journal of diabetes and its complications [J Diabetes Complications] 2026 Sep; Vol. 40 (9), pp. 109366. Date of Electronic Publication: 2026 Jul 09. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Science Pub. Co Country of Publication: United States NLM ID: 9204583 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-460X (Electronic) Linking ISSN: 10568727 NLM ISO Abbreviation: J Diabetes Complications Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier Science Pub. Co., c1992- |
| Ιατρικοί όροι (MeSH): | Diabetic Foot*/mortality , Diabetic Foot*/therapy , Diabetic Foot*/ethnology , Jews*/statistics & numerical data , Hospitalization*/statistics & numerical data , Healthcare Disparities*/ethnology , Healthcare Disparities*/statistics & numerical data , Health Status Disparities*, Israel/epidemiology ; Arabs/statistics & numerical data ; Hospital Mortality/ethnology ; Humans ; Male ; Retrospective Studies ; Female ; Aged ; Middle Aged |
| Περίληψη: | Aim: To examine ethnicity-based differences in mortality among Arab and Jewish patients hospitalized with a diabetic foot ulcer (DFU) in Israel, aiming to address disparities in diabetes care. Methods: We conducted a single-center retrospective cohort study including all adults admitted to the multidisciplinary diabetic foot unit (2015-2019) with a DFU. Baseline demographics, comorbidities, ulcer severity, laboratory data, and outcomes were collected from electronic medical records. Outcomes included in-hospital mortality, vascular interventions, amputations, one-year mortality, and long-term mortality through 2023. We assessed the association between ethnicity and survival using Cox proportional regression models adjusted for multiple covariates. Sex-stratified analyses were also performed. Results: The cohort comprised 535 patients (325 [60.7%] Jews, 210 [39.3%] Arabs). DFU severity was similar across ethnicities. Arabs presented younger (62.9 ± 11.4 vs. 66.0 ± 12.8 years, p = 0.004) with higher admission glucose-levels (13.8 ± 6.7 vs. 11.4 ± 5.7 mmol/L, p < 0.001). In-hospital mortality was comparable overall (6.5% vs. 5.2%, p = 0.560), but Jewish women had higher rates than Arab women (14.3% vs. 3.1%, p = 0.022). One-year mortality was higher among Arabs (27.1% vs. 19.7%, p = 0.044), driven by men (29.7% vs. 19.6%, p = 0.022). Over a median follow-up of 3.8 years, Arab ethnicity was associated with poor survival (HR 1.31, 95% CI 1.01-1.71; p = 0.043), driven by poor survival among Arab men (HR 1.36, 95% CI 1.04-1.78; p = 0.024). Conclusions: Among patients hospitalized with DFU, Arab men experienced higher long-term mortality despite comparable inpatient care. These findings highlight the importance of equitable post-discharge care and culturally tailored chronic disease management strategies to address persistent disparities in social determinants of health. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest All authors declare no conflicts of interests. |
| Contributed Indexing: | Keywords: Arabs; Diabetes; Diabetic foot ulcer; Ethnicity; Inequity; Jews; Minority |
| Entry Date(s): | Date Created: 20260715 Date Completed: 20260731 Latest Revision: 20260731 |
| Update Code: | 20260801 |
| DOI: | 10.1016/j.jdiacomp.2026.109366 |
| PMID: | 42456523 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1873-460X |
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| DOI: | 10.1016/j.jdiacomp.2026.109366 |