Characteristic of Diabetic Foot Ulcer Patients Across Varying Clinical Outcomes: Diabetic Foot Registry of a National Referral Hospital in Indonesia
Eni Iswati (a), Em Yunir (a,b*)

a) Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
b) Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
*e.yunir[at]ui.ac.id

Abstract

Background:
Diabetic foot ulcer (DFU) is a common complication in diabetes. There are some outcomes of DFU, including healing, amputation, and mortality. Identifying of DFU characteristics is crucial to predict the prognosis.
Purpose:
This study aimed to describe characteristics of DFU patients across varying clinical outcomes.
Methods:
A retrospective cohort study was conducted using diabetic foot registry. This study involved DFU patients from January 2019 to December 2024. Comparability of characteristics between outcome groups was assessed using Chi-Square test for categorical variables and One-way ANOVA or Kruskal-Wallis for continuous variables.
Results:
This study involved 286 DFU patients with different outcomes, including amputation (112 patients), mortality (36 patients), and those discharged without amputation and mortality (120 patients). There was a significant difference in severity of infection (p<0.001), number of lesions (p=0.040), osteomyelitis (p=0.002), leukocyte (p<0.001), NLR (p<0.001), and albumin (p <0.001) between the outcome groups. The mortality group had the highest proportion of severe infection (83.3%) and the number of lesions of more than six areas (30.6%), and also had the highest levels of leukocyte (21,735/&#61549-L) and NLR (14.7), with the lowest albumin (2.4 g/dL). The highest proportion of osteomyelitis was found in the amputation group (91.7%). Meanwhile, those without amputation and mortality had the lowest proportion of severe infection (53.3%) and the number of lesions more than six areas (12.2%), and also had the lowest of leukocyte levels (14,940/&#61549-L) and NLR (8.1), with the highest level of albumin (2.9 g/dL).
Conclusion:
Mortality group had the highest proportion of severe infection and the number of lessions more than six areas, and had the highest levels of leukocyte and NLR, with the lowest of albumin. It was contrary to those without amputation and mortality. Meanwhile, amputation group had the highest proportion of osteomyelitis.

Keywords: Diabetic foot ulcer, amputation, mortality, without amputation and mortality

Topic: Other