Abstract
ABSTRACT Background: This study attempted to determine the disease burden in terms of clinical profile and outcome of diabetic foot ulcer (DFU) admissions at a tertiary care hospital in a developing country. Methods: In this descriptive study, the data were collected from the medical record of diabetic patients with foot ulcer who were treated in Dr. Kariadi General Hospital during a 3-year period. The demographic characteristic, type of foot lesion, etiology, isolated microorganism, treatment, and outcome were reviewed. Results: Foot problems accounted for 16.2% of total diabetic admission (n = 1429). All patients had type 2 diabetes with no gender predominance. The mean age was 54.3 ± 8.6 years and diabetes control was very poor. Before admission, the ulcers had already developed for 4.7 ± 2.9 weeks; however, the majority of patients were unaware of the preceding causes. Ulcers were neuropathic in 42.2% of cases, neuroischemic in 29.9%, and pure ischemic at lesser percentage. More than 70% of ulcers were in Wagner grade ≥3 with infection event in nearly all patients. The most common isolates from culture were Gram-negative bacteria. A total of 98 (36.3%) lower extremity amputations (LEAs) at various level of the foot were carried out, including major LEA in 24 patients and multiple amputations in seven patients. Mortality rate due to DFU reached 10.7%. Conclusions: Diabetic foot problems constitute a source of morbidity, a reason for LEA surgery as well as being a cause of death among patients with diabetes mellitus.
Highlights
Diabetes is one of the most prevalent chronic diseases: in 2010, one study reported that 285 million adults worldwide had diabetes and this figure is projected to rise to 439 milion by the year 2030 [1]
This study is a retrospective study reviewing the medical records of diabetic patients who were admitted to the Dr Kariadi General Hospital with foot problems
Our study documented a 16.2% prevalence rate of diabetic foot ulcer (DFU) among consecutive, unselected diabetic patients admitted to the largest medical inpatients service in Semarang, Indonesia
Summary
Diabetes is one of the most prevalent chronic diseases: in 2010, one study reported that 285 million adults worldwide had diabetes and this figure is projected to rise to 439 milion by the year 2030 [1]. Such a profound demographic shift is likely to yield a corresponding increase in the prevalence of diabetes chronic complications, including those in the lower extremity, the diabetic foot [2]. This study attempted to determine the disease burden in terms of clinical profile and outcome of diabetic foot ulcer (DFU) admissions at a tertiary care hospital in a developing country. Conclusions: Diabetic foot problems constitute a source of morbidity, a reason for LEA surgery as well as being a cause of death among patients with diabetes mellitus
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