Characteristics and Outcomes of Patients Admitted for Diabetic Foot Attack

Abstract

The current study aimed to evaluate characteristics and outcomes of patients admitted for a diabetic foot attack (DFA). It is a retrospective observational study including a population of patients admitted for diabetic foot ulcers (DFU) in a specialized diabetic foot service. Based on the type of hospital admission (emergency or elective), patients were divided into two groups: those with DFA and those without DFA (chronic diabetic foot, CDF). The DFA was considered in case of ischemia, infection and Charcot foot requiring urgent hospitalization. The following in-hospital outcomes were evaluated: minor and major amputation, number of surgical procedures, length of stay (LOS), mortality. Overall, 150 patients were included. The mean age was 70.3 ± 12.2 years, most patients were male (76.0%) and had type 2 diabetes (92.7%) with a mean duration of 22.1 ± 13.2 years; 88 (58.7%) patients presented DFA while 62 (41.3%) presented CDF. The DFA group reported a greater rate of foot infection (81.8 vs 50.0%, p = 0.002), higher HbA1c values (67.9 ± 22 vs 56.6 ± 14.3 mmol/mol, p = 0.0005) and more cases of first assessment for DFUs (43.2 vs 12.9%, p = 0.005) compared with the CDF group. Outcomes for DFA and CDF were minor amputation (36.4 vs 21%, p = 0.04), major amputation (2.3 vs 1.6%, p = 0.7), need for surgical procedures (>1) (27.3 vs 11.3%, p = 0.0001), LOS (17 ± 9.6 vs 12 ± 6.3 days, p = 0.0004), mortality (1.1 vs 0%, p = 0.6). In addition, foot infection and poor glycometabolic control were independently related to the DFA presentation. The DFA increases the risk of minor amputations, more surgical procedures and longer hospitalization. Foot infection and poor metabolic control resulted closely related to the DFA.