Diabetes foot ulceration in a Nigerian hospital: in‐hospital mortality in relation to the presenting demographic, clinical and laboratory features

Ekpebegh, Chukwuma; Fasanmade, O.A; Ogbera, Anthonia O; Igumbor, Ehimario; Ohwovoriole, A.E

doi:10.1111/j.1742-481x.2009.00627.x

Cited by 37 publications

(44 citation statements)

References 19 publications

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“…Anemia was common in our patients with DFUs as in previous reports 820. This could result from foot sepsis, malnutrition (poor dietary intake in ill patients) and DM nephropathy 821.…”

Section: Discussionsupporting

confidence: 75%

Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Edo

Ezeani

2013

Niger Med J

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Background:The objective was to determine the risk factors, ulcer grade, and management outcome of patients with diabetic foot ulcers (DFU) managed in a tropical tertiary hospital.Materials and Methods:This is a prospective observational study of all consecutive diabetes mellitus (DM) patients with DFU admitted in the University of Benin Teaching Hospital, Benin City, Nigeria over a 26-month period. Data documented included age, gender, type of DM, duration of DM, risk factors of DFU, duration of DFU, Wagner's ulcer grade, and the blood glucose at presentation and management outcome.Results:Thirty-four (55.7%) of the 61 study subjects were females. Their mean age was 56.29±12.71 years. 85.2% had type 2 DM. 13.1% of the patients were newly diagnosed diabetic at presentation. The mean duration of DM was 7.8±6.98 years. The mean duration of DFU was 46.09±47.82 days and the casual blood glucose level at presentation was 18.41±9.31mmol/l. Risk factors of DFU included spontaneous blisters (52.46%), peripheral vascular disease (44.3%), peripheral neuropathy (42.6%), and visual impairment (21.3%). The common ulcer grades were IV (44.3%) and III (36.1%).The amputation rate was 52.2% while the mortality rate was 14.3%.The baseline ulcer grade was significantly associated with the risk of lower extremity amputation, and the odds ratio was 2.36 (95% 1.06-5.21).Conclusions:Spontaneous blisters, peripheral vascular disease, peripheral neuropathy,and visual impairment are common risk factors of DFUs. Many of our patients with DFUs presented with grade IV and V ulcers with the resultant high rate of lower extremity amputations (LEAs). Early presentation and treatment of DFUs will reduce LEAs.

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“…Anemia was common in our patients with DFUs as in previous reports 820. This could result from foot sepsis, malnutrition (poor dietary intake in ill patients) and DM nephropathy 821.…”

Section: Discussionsupporting

confidence: 75%

Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Edo

Ezeani

2013

Niger Med J

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“…A previous retrospective study suggested the existence of a relationship between anemia and clinical stages of DFU [18] . We found that 63% of IDFU patients have anemia which is in agreement with previous studies where 57% of 47 patients with DFU (2-3 Wagner grade) were anemic [24] , while in a study enrolled all Wagner grades (1)(2)(3)(4)(5), the percent of anemia was 62% of 42 patients with DFU [25] . Fengning et al (2016) [26] study the variables in the DFU patients with and without anemia.…”

Section: Discussionsupporting

confidence: 80%

Low Hemoglobin Levels in Infected Diabetic Foot Ulcer

Salman¹,

Wadood²,

Abualkasem³

2017

IOSRJPBS

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“…In a similar prospective case series of forty-seven DFU patients (this patient cohort included Wagner grades 2-3) 57% of patients were classified as “anaemic” [15]. Further cross sectional study of forty-two Nigerian patients with all grades of DFU (Wagner grade 1–5) showed that 61.8% of patients had “anaemia,” which was found to be a significant risk factor for in-hospital mortality [16]. Our study in the UK provides some evidence to suggest that the anaemia observed in severe DFU patients may be more than nutritional in its nature.…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Ekpebegh et al [16], leucocytosis was shown to be a significant risk factor for inpatient mortality, although association between Hb decline and other inflammatory markers was not described. Our finding of ESR being elevated at initial visit is most likely related to the inflammatory and infective processes occurring in DFU.…”

Section: Discussionmentioning

confidence: 99%

Presence and Characterisation of Anaemia in Diabetic Foot Ulceration

Wright

Oddy

Richards

2014

Anemia

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Introduction. Diabetic foot ulceration (DFU) is the commonest cause of severe limb ischaemia in the western world. In diabetes mellitus, anaemia is frequently unrecognized, yet studies have shown that it is twice as common in diabetics compared with nondiabetics. We aimed to assess the incidence of anaemia and further classify the iron deficiency seen in a high-risk DFU patient group. Methods. An observational study was undertaken in a multidisciplinary diabetic foot clinic setting. All patients with DFU attending over a four-month period were included. Anaemia was defined as haemoglobin (Hb) levels <12 g/dL. Iron deficiency was classified according to definitions of AID (absolute iron deficiency) and FID (functional iron deficiency). Results. 27 patients had DFU; 14 (51.9%) were anaemic; two (7.41%) had severe anaemia (Hb < 10 g/dL). No patient had B12 or Folate deficiency. In patients with anaemia, there was significant spread of indices. Only one patient had “textbook” absolute iron deficiency (AID) defined as low Hb, MCV, MCH, and ferritin. Functional iron deficiency (FID) was seen in a further seven patients (25.5%). Conclusion. Anaemia and iron deficiency are a common problem in patients with DFU. With current clinical markers, it is incredibly difficult to determine causal relationships and further in-depth scientific study is required.

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Diabetes foot ulceration in a Nigerian hospital: in‐hospital mortality in relation to the presenting demographic, clinical and laboratory features

Cited by 37 publications

References 19 publications

Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Low Hemoglobin Levels in Infected Diabetic Foot Ulcer

Presence and Characterisation of Anaemia in Diabetic Foot Ulceration

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