Assessment of the Outcome of Diabetic Foot Ulcers in Basrah, Southern Iraq: A Cohort Study

Abstract

Background: Diabetic foot ulcers are one of the most severe and costly complications of diabetes. Foot ulcers result from a combination of multiple causes including peripheral neuropathy and peripheral arterial disease. Patients with diabetic foot ulcers frequently require amputation of the lower limb. Objectives: The aim of this study was to assess the outcome of diabetic foot ulcers among Iraqi patients with diabetes and to examine the effect of some risk factors on healing of the ulcer. Methods: A cohort study was conducted on 100 patients from January to August 2017 at the Diabetic Foot Clinic, Alfayha Teaching Hospital, Basrah, Iraq. Results: A total of 100 patients with diabetic foot ulcers were included. The ulcers of 60% of the patients healed, whereas 8% persisted unhealed; 25% of the patients had a minor amputation, 5% had a major amputation, 1% had recurrent ulcers, and 1% died. The study showed statistically significant associations between diabetic foot ulcer healing and the following variables: patients’ age, glycated HbA_1c, duration of diabetes, complications of diabetes like peripheral neuropathy, and ulcer size. Conclusions: Diabetic foot ulcer outcomes can be predicted by several factors, some of which are modifiable. Modification of the modifiable factors, such as better control of diabetes, treatment of peripheral neuropathy, and early management of ulcers, may improve the outcome and facilitate healing.