Clinical and behavioral factors associated with management outcome in hospitalized patients with diabetic foot ulcer

Abstract

Objectives: Diabetic foot ulcer (DFU) has been linked to high mortality and morbidity in diabetic patients. In spite of the increasing prevalence of diabetes and its complications, this issue has not been adequately studied in Iran. Materials and methods: In this cross-sectional study we attempt to describe the prevalence of diabetic foot amputation in patients admitted to our training hospitals in Urmia, Iran, and also to determine the associated demographic, behavioral, and clinical factors. Results: Of 94 patients with DFU, 34 (32%) had amputation. Those with amputation were significantly older and were also less educated than those without amputation, had longer duration of diabetes (hence were more likely to suffer from complications), and had high-risk wounds plus a poor glycemic control. On logistic regression analysis two variables were associated with amputation: Wagner classification ≥3 and HbA_1c. On a receiver operating characteristics curve, the HbA_1c cutoff point of 9.7% significantly discriminated to predict increasing risk of amputation. Conclusion: Both glycemic control and promoting the knowledge of patients and health care professionals in order to diagnose DFU in the early stages and to prevent development of the high-grade wounds would be a significant step in reducing the burden of DFU and its effect on quality of life in Iran.