Factors Associated with the Improvement of Patients with Leg Ulcers Treated at an In-patient Dermatology Service: A Cohort Study

Abstract Background: Leg ulcers represent a global health challenge, especially affecting women and older individuals, leading to significant morbidity and a decrease in the quality of life. Its inter-disciplinary management puts economic strain on health systems. Dermatologists are frequently consulted; however, data on factors associated with healing are scarce. Aims and Objectives: To provide data on factors associated with improvement of leg ulcers. Methods: A retrospective cohort study approved by CES University Human Research Ethics Committee, following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, was carried out. Medical records of patients with lower limb ulcers referred to the Dermatology Service of a tertiary hospital in Medellín, Colombia, between 2015 and 2022 were reviewed. Entry was defined as the dermatological consultation, with follow-up until specialised discharge. Results: Among 207 patients, 63.8% (n = 132) were women, with an average age of 64 years, and 40% had previously had ulcers. Co-morbidities, such as hypertension, diabetes, anaemia, malnutrition, and internal malignancy, were associated with a lower probability of improvement. Deeper ulcers were statistically significantly associated with a poor response to treatment. Specific topical and systemic treatments were positively correlated with improvement. Conclusions: Several factors highlight the need for timely recognition of lower limb ulcers. A poor response to treatment correlates with pain, ulcer depth, diabetes, and malnutrition, emphasising the need for multi-disciplinary management for effective results.