Background: Diabetic Foot Ulcer (DFU) has been associated with a high mortality rate of Diabetes Mellitus (DM) patients. Both behavioral and biological factors cause predisposition to DFU. Purpose: This research describes the profile of hospitalized DFU patients at a tertiary care hospital in Surabaya. Methods: A retrospective descriptive study that analyzed medical records of hospitalized T2DM patients with DFU in Dr. Soetomo General Hospital. Sampled respondents were patients ≥ 21 years old who were hospitalized between 2016–2018. Demographic data, clinical characteristics, medical histories, length of hospital stay, laboratory results, precipitating factors, microorganism culture results, treatment, and outcome were analyzed. Descriptive analysis is presented in the form of narratives, tables, and diagrams. Results: 9.08% of hospitalized Type 2 DM (T2DM) cases were related to foot ulcers. The average patient age was 57.00 ± 9.83 years with no gender predominance. DM was poorly controlled (Mean HbA1C 9.78±2.83%; RBG 251.83 ± 158.15 mg/dL). The majority of patients had sepsis (68.26%) and renal function impairment (62.72%). Ulcers with Wagner grades of 4–5 were frequent (41.31%). The highest percentage of sepsis (80.49%) and the average leukocyte level (22.60±11.95 x109/L) were found in gangrenous feet. Anemia was more predominant and severe in ulcers with higher Wagner grades. Trauma and Escherichia coli were the most common precipitating factors and microorganisms isolated, respectively. Amputation was performed for 82.36% of patients who were admitted to hospital with gangrene. The Lower Extremity Amputation (LEA) and mortality rates were 14.11% and 40.93%, respectively. Conclusion: DFUs were found to have a relatively high prevalence among T2DM patients, and must never be neglected due to the high associated mortality rate.
Objective: Diabetic foot ulcers (DFUs) are a diabetes mellitus (DM) complication with a high mortality rate. This research aimed to demonstrate a mortality prediction model in patients with DFUs.Material and Methods: This research conducted a case-control study based on secondary data from the medical records of DFU patients in Dr. Soetomo General Hospital, a tertiary referral hospital in Surabaya, Indonesia, between 2016-2018. The association between various risk factors and mortality was analyzed using bivariate and multivariate analyses to make a mortality prediction model.Results: 358 subjects (179 cases and 179 controls) were included in the final analysis. Septic shock was the major cause of DFU death. Both bivariate and multivariate analyses determined that 5 independent variables were associated with the mortality in DFU patients, namely albumin level (p-value<0.001 OR 16.52 CI 95% 3.42–79.86), sepsis (p-value<0.001 OR 23.47 CI 95% 5.80–26.85), renal function impairment (p-value<0.001 OR 3.41 CI 95% 1.87–6.21), cardiovascular complications (p-value<0.001 OR 2.93 CI 95% 1.64–5.25), and the severity level of the ulcers using Wagner’s classification (p-value<0.001 OR 6.80 CI 95% 3.77–12.27). The mortality prediction model showed a maximum score of 7, indicating a 98.4% mortality risk.Conclusion: Low albumin level, sepsis, renal function impairment, cardiovascular complications, and Wagner’s severity level IV–V of the DF ulcers were the predictors of mortality in DFUs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.