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Clinical Summary

Diabetes linked to 2-fold higher risk for hospital-acquired foot ulcers

Takeaway

  • Risk for hospital-acquired foot ulcers (HAFU) is at least 2-fold greater among people with diabetes vs those without diabetes.

Why this matters

  • Patients with diabetic foot ulceration are at increased risk of progression to more serious complications including cellulitis, necrosis, osteomyelitis, septicaemia, amputation, and death.
  • Study highlights the association between people with diabetes for HAFU and aims to increase awareness of this risk among physicians.

Study design

  • About 2 years of hospital inpatient data were collected and patient with diabetes (n=5043; aged >50 years; ≥48 hours after admission) were compared with patients without diabetes (n=23,599) to analyse the risk for HAFU.
  • Funding: The Diabetes Centre Research Funds.

Key results

  • Significant differences between patients with diabetes and without diabetes among a range of covariates including:
    • sex (% male): (52.2% vs 45.4%; P<.001);
    • comorbidity score: (3.01 vs 2.27; P<.001) and
    • length of hospital stay: 7 vs 6 days (median interquartile range [IQR], 2-39 vs 2-33 days, respectively; P<.001).
  • After adjustment for confounders, persistent significant increase in the risk for HAFU was seen in patients with diabetes (OR, 2.24; 95% CI, 1.87-2.62).
  • No substantial differences between clinically relevant subgroups.

Limitations

  • Some community-acquired foot ulcers were not identified.
  • Grade 1 ulcers not included.

References


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