Analysis of risk factors of infection in diabetic foot patients

Abstract

This cross‐sectional study assessed the risk factors for infection in 150 diabetic foot patients admitted to the Xiamen University Hospital between October 2020 and October 2022. Patients were categorised as infected (n = 80) or uninfected (n = 70) cohorts. The diabetic foot was evaluated using the American Diabetic Foot Grading system, whereas ulcers were categorised using Wagner's method. Analysed were patient‐specific information, clinical data and risk factors including neuropathy, arterial disease and foot deformities. Our findings revealed no statistically significant differences between infected and uninfected cohorts concerning age, body mass index, gender, duration of diabetes or ankle‐brachial index values (p > 0.05). However, infected group had a higher proportion of smokers and reduced socio‐economic status (p < 0.05). Wagner grades indicated a greater severity in the infected group, with grade 3, grade 4 and grade 5 differing significantly (p < 0.05). Comparative analysis of ulcer characteristics revealed no statistically significant differences in ulcer surface area and depth, but the infected group had a higher prevalence of osteomyelitis and a greater number of ulcers (p > 0.05). Blood vessel complications, retinopathy, the presence of three or more ulcers, osteomyelitis and diabetic nephropathy were substantially more prevalent in the infected group, as determined by univariate analysis (p < 0.05). Subsequent multivariate logistic analysis revealed that patients with blood vessel complications, retinopathy, osteomyelitis, diabetic nephropathy and three or more ulcers were at increased risk for infection (p < 0.05). In addition, lifestyle factors, such as smoking, sedentary behaviour, inadequate foot hygiene, obesity and poor glycaemic control, were also associated with higher infection rates. A multivariate analysis of foot wound factors revealed that deeper, longer and recurrent lesions increased the likelihood of infection. Escherichia coli was the most frequently isolated bacterium from the infected group's bacterial culture, followed by Pseudomonas aeruginosa and Staphylococcus aureus. The study enhanced our comprehension of the multifactorial risk factors associated with infections in diabetic foot patients, highlighting the need for thorough clinical evaluation, lifestyle modification and vigilant infection control.

Characteristics and outcomes of diabetic foot ulcers treated with surgical debridement and standardized wound care

“…This stark reality emphasises the critical importance of understanding, managing and preventing the complications associated with DFUs. Risk factors for DFUs include prolonged diabetes duration, male gender, poor glycemic control and existing cardiovascular, renal or ocular comorbidities 6,7 . These risk factors highlight the need for tailored and comprehensive approaches to address the unique circumstances of each patient.…”

“…Risk factors for DFUs include prolonged diabetes duration, male gender, poor glycemic control and existing cardiovascular, renal or ocular comorbidities. 6 , 7 These risk factors highlight the need for tailored and comprehensive approaches to address the unique circumstances of each patient. The pathophysiology of DFUs is complex, often involving a combination of ischemia, neuropathy and infection.…”

Perawatan Luka Diabetik Di Rumah Pada Pasien Diabetes Mellitus Yang Pernah Dirawat Di Rumah Sakit

“…Infeksi kaki mudah timbul pada penderita diabetes kronis dan dikenal sebagai penyulit gangren atau ulkus. Jika infeksi dibiarkan maka akan mengakibatkan pembusukan pada bagian luka karena tidak mendapat aliran darah (Hsu et al, 2024). Jika luka telah membusuk, maka mau tidak mau bagian yang terinfeksi harus di amputasi.…”