Outcome of diabetic foot ulcer admissions at the medical wards of University of Nigeria Teaching Hospital Enugu, Nigeria

Abstract

Diabetic foot ulcer (DFU) is associated with a high rate of morbidity, prolonged hospital stay, and serious complications including limb amputation. The objective of this study was to determine the outcome of DFU among medical inpatients in the University of Nigeria Teaching Hospital Enugu, Nigeria. Data from case records of diabetes-related admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu (UNTH) between January 2009 and December 2012 were analyzed. Statistical analysis was done using SPSS v17. Out of 726 diabetes mellitus (DM)-related admissions (59.1 % males, 40.9 % females), DFU accounted for 119 (16.4 %), of which 65.5 % were males and 34.5 % were females. The mean duration of diabetes in DFU patients was 7.2 ± 5.8 years, while the median (interquartile range) duration of the ulcer before the presentation was 24 (14–60) days. The mean age of patients with DFU was 55.2 ± 13.2 years, while the duration of hospital stay ranged from 2 to 98 days, median (interquartile range (IQR)) of 16 (9.8–30.3) days. Out of the 119 DFU admissions, 88 (73.9 %) were discharged, 15 (12.6 %) died, while 16 (13.5 %) discharged themselves against medical advice (DAMA). Of those who were discharged, about 75 % were discharged with non-healed ulcers either for outpatient care or to surgical units. The most common Wagner grade of ulcer was grade 3 (41.5 %). Risk factors for ulceration were peripheral vascular disease in 47.1 % and peripheral neuropathy in 57.6 %. Mortality due to DFU accounted for 10.6 % of all diabetes mortality. Diabetic foot ulcer was a common reason for admission and characterized by late presentation and advanced ulcer stage. Diabetes foot ulcers admitted and managed in the medical wards were associated with poor outcome.