Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Indonesia

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.

Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

“…Vancomycin resistance in Staphylococcus aureus among diabetic patients with foot lesion was also reported by Oates et al [26]. However, different susceptibility patterns to antibiotics have been shown by other studies and, mostly, vancomycin, amikacin and linezolid have shown good activity against the strains [27] - [30], which is in agreement with findings of the present study. The challenge of antibiotic resistance is a major public health concern, due to its global dimension and alarming magnitude, although the epidemiology of resistance can exhibit remarkable geographical variability and rapid temporal evolution.…”

Prevalence and risk factors of diabetic foot ulcer at a tertiary care hospital among diabetic patients

“…15 Pemayun TG et al, found that 16.2% were having diabetic foot which is similar to the present study. 10 The mean age in their study was 54.3±8.6 years. The patients were not aware about the causes of ulcer.…”

“…Based on the findings of the previous study it was found that the prevalence of diabetic foot ulcer among diabetic patients was 15%. 9,10 Using this prevalence with 95% confidence interval with 5% precision and alpha error of 5% the sample size came out to be 196. It was rounded to 200.…”

Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

“…Patients with DF ulcer accompanied by infections are commonly encountered in clinical settings. According to a literature review, the length of hospital stay (LHS) serves as an important outcome of DF [ 4 , 5 ]. Still, however, few studies have investigated LHS.…”