The infected diabetic foot: Analysis of diabetic and non‐diabetic foot infections

Author:

Lavery Lawrence A.1,Suludere Mehmet A.1ORCID,Ryan Easton2,Crisologo Peter A.1,Tarricone Arthur1,Malone Matthew3ORCID,Oz Orhan K.4

Affiliation:

1. Department of Plastic Surgery University of Texas Southwestern Medical Center Dallas Texas USA

2. Resident Department of Orthopedics Harvard University Medical School Boston Massachusetts USA

3. School of Medicine, Infectious Diseases and Microbiology Western Sydney University Sydney New South Wales Australia

4. Department of Radiology University of Texas Southwestern Medical Center Dallas Texas USA

Abstract

AbstractThe aim of this study was to compare outcomes of moderate and severe foot infections in people with and without diabetes mellitus (DM). We retrospectively evaluated 382 patients (77% with DM and 23% non‐DM). We collected demographic data, co‐morbidities and one‐year outcomes including healing, surgical interventions, number of surgeries, length of stay, re‐infection and re‐hospitalisation. DM patients required more surgeries (2.3 ± 2.2 vs. 1.7 ± 1.3, p = 0.01), but did not have a longer hospital length of stay during the index hospitalisation (DM 10.9 days ±9.2 vs. non‐DM = 8.8 days ±5.8, p = 0.43). After the index hospitalisation, DM patients had increased rates of re‐hospitalisation for any reason (63.3% vs. 35.2%, CI 1.9–5.2, OR 3.2, p < 0.01), re‐infection at the index wound infection site (48% vs. 30.7%, CI 1.3–3.5, OR 2.1, p < 0.01), re‐hospitalisation for a foot pathology (47.3% vs. 29.5%, CI 1.3–3.6, OR 2.1, p < 0.01), and longer times to ulcer healing (151.8 days ±108.8 vs. 108.8 ± 90.6 days, p = 0.04). Patients with DM admitted to hospital with foot infections have worse clinical outcomes during the index hospitalisation and are more likely to have re‐infection and re‐admission to hospital in the next year.

Publisher

Wiley

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