Prevalence and Determinants of Diabetic Foot Ulcers and Lower Extremity Amputations in Three Selected Tertiary Hospitals in Ghana

Atosona, Ambrose; Larbie, Christopher

doi:10.1155/2019/7132861

Cited by 48 publications

(64 citation statements)

References 36 publications

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“…Totally 336 patients participated in this study. The mean ± SD age was 55.9±12.5 years, showing that our study population is largely middle aged, which is in keeping with findings from other studies (Atosona and Larbie 2019;Djibril et al 2018;Saleem et al 2017). About 96% of the patients in this study had type 2 diabetes, similar to findings from other studies, which reported type 2 diabetes as the commonest type of diabetes (Mehmood et al 2008;Pemayun and Naibaho 2017).…”

Section: Discussionsupporting

confidence: 92%

Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

Ezeani¹,

Ugwu

Adeleye

et al. 2020

Endocrine Regulations

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Objective. The high amputation rates from diabetic foot ulcer (DFU) in Nigeria and prolonged hospitalization due to poor wound healing is a source of concern. Furthermore, factors that affect wound healing of DFUs have not yet been well studied in Nigeria, whereas knowing these factors could improve DFU outcomes. Therefore, the objective of this study was to determine the factors that are associated with the wound healing in patients hospitalized for DFU.Methods. The Multi-Center Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN) was an observational study involving 336 diabetic patients hospitalized for DFU and managed by a multi-disciplinary team until discharge or death. Demographic, clinical, and biochemical characteristics were documented. Test statistics used were chi square, t-test, univariate, and multivariate logistic regression. The study endpoints were ulcer healing, LEA, duration of hospitalization, and mortality. Here we present data on wound healing.Results. The mean ± SD age was 55.9±12.5 years. Univariate predictors of wound healing were ulcer duration more than 1 month prior to hospitalization (p<0.001), peripheral arterial disease (PAD) (p<0.001), foot gangrene (p<0.001), Ulcer grade ≥3 (p=0.002), proteinuria (p=0.005), anemia (p=0.009), renal impairment (p=0.021), glycated hemoglobin ≥7% (0.012), and osteomyelitis (p<0.001). On multivariate regression, osteomyelitis was the strongest independent predictor of wound healing after adjusting for all other variables (OR 0.035; 95% CI 0.004–0.332). This was followed by PAD (OR 0.093; 95% CI 0.028–0.311), ulcer duration >1 month (OR 0.109; 95% CI 0.030–0.395), anemia (OR 0.179; 95% CI 0.056–0.571).Conclusion. Presence of osteomyelitis, duration of ulcer greater than 1 month, PAD, Wagner grade 3 or higher, proteinuria, presence of gangrene, anemia, renal impairment, and HbA1c ≥7% were the significant predictors of wound healing in patients hospitalized for DFU. Early identification and prompt attention to these factors in a diabetic foot wound might significantly improve healing and reduce adverse outcomes such as amputation and death.

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Section: Discussionsupporting

confidence: 92%

Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

Ezeani¹,

Ugwu

Adeleye

et al. 2020

Endocrine Regulations

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“…Sixty-seven percent (66) of the new diabetes-related LEA patients had one or more medical complications indicating a need for specialised services. The above findings show a much lower rate of diabetes-related LEA than the 3% prevalence reported from three tertiary hospitals in Ghana [16] and the overall rate of major amputation of 11.1% reported from a retrospective review of medical records of consecutive type 2 diabetes patients referred for diabetes management to King Abdullah University Hospital (KAUH) in the period between January 2014 and December 2015 [17]. Several different studies have reported rates of 2%-16% [18].…”

Section: Discussionmentioning

confidence: 56%

Patient-level predictors of diabetes-related lower extremity amputations at a quaternary hospital in South Africa

Mtshali¹,

Mahomed²

2020

PLoS ONE

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Introduction Diabetes-related lower extremity amputation has a major psycho-social and economic cost on the patient as well as a direct impact on financial expenditure within health facilities. Aim This study aimed to determine the incidence and patient-related factors related to diabetesrelated amputations amongst patients that were referred to the quaternary hospital between 1 January 2014 and 31 December 2015. Methods A retrospective cohort study. Data were retrieved from the medical record for each diabetes patient that was managed at IALCH during the study period. The following variables were collected: sociodemographic parameters (age, gender, and ethnicity) and diabetes-related parameters (type of diabetes) and additional complications. Results Ninety-nine patients (0, 73%) of all diabetes patients managed were new diabetes-related lower-extremity amputations. There were statistically significant increased odds of female patients (OR: 1, 7) and patients with non-insulin dependent diabetes (OR: 1, 64) to have new diabetes-related amputations. Patients older than 60 years (OR: 1, 31); African patients (OR: 1, 35) patients with cardiovascular complications (OR: 1, 04) and patients with retinopathy (OR: 1, 48) were more likely to have diabetes-related amputations but not statistically significant. Conclusions A combination of primary preventive strategies, early detection and appropriate management of patients with diabetes and specific guidelines on the frequency, clinical and

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“…There were, however, other studies that showed insignificant correlation between smoking and risk of diabetic foot problem. 18,19 This study has shown that duration of diabetes more than 10 years had one-time risk of developing foot at risk. This is again was similar to a study done by Che Ahmad (2012) whereby the prevalence of foot at risk is higher in diabetic with duration more than 10 years (59.9%).…”

Section: Awareness and Practice Levelmentioning

confidence: 90%

Prevalence and Associated Factors of Diabetic Foot at Risk among Type 2 Diabetes Mellitus Patients Attending Primary Health Clinics in Kuantan

Nh¹,

Hadi²,

Aris³

et al. 2020

imjm

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Introduction: The diabetic foot at risk is the diabetic foot which is at risk of ulceration, hence the importance of identifying the foot at this stage. This study aims to assess the prevalence of diabetic foot at risk and its associated factors among type 2 diabetes mellitus patients’ attending primary health clinics in Kuantan. Methods and methods : This was a cross-sectional study conducted at four primary health clinics in Kuantan involving 450 study participants who were selected by using universal sampling method. Foot examination was carried out and foot at risk was classified based on the Kings’ Classification. Multiple logistic regressions were performed to identify the predictors for diabetic foot at risk. Results: The prevalence of diabetic foot at risk was 31.3%. Multivariate logistic regression analysis identified age (OR 1.04, 95% CI: 1.01-1.06), smoker (OR 4.11, 95% CI: 1.96-8.63) and duration of diabetes more than 10 years (OR1.77, 95% CI: 1.05-2.98) as risk factors for diabetic foot at risk. Respondents with higher diabetic foot practice score (OR 0.87, 95% CI: 0.77-0.98) have lesser risk of developing diabetic foot at risk. Conclusion: Patients who are older, smoker and/or have chronic diabetes are predicted to be at higher risk to develop the diabetic foot at risk. This study also showed that patients with better foot care practice has lesser risk. Therefore, these are the groups of patients that need to be targeted for early detection and intervention to prevent serious complications.

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Prevalence and Determinants of Diabetic Foot Ulcers and Lower Extremity Amputations in Three Selected Tertiary Hospitals in Ghana

Cited by 48 publications

References 36 publications

Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

Patient-level predictors of diabetes-related lower extremity amputations at a quaternary hospital in South Africa

Prevalence and Associated Factors of Diabetic Foot at Risk among Type 2 Diabetes Mellitus Patients Attending Primary Health Clinics in Kuantan

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