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Diabetic Foot Ulcer Registry at a Tertiary Care Hospital in Semarang, Indonesia: an Overview of its Clinical Profile and Management Outcome

Tjokorda Gde Dalem Pemayun and Ridho M Naibaho

Aim: To determine the disease burden in terms of clinical profile and management outcome of diabetic foot complication at a tertiary care hospital in a developing country.
Material and methods: In this descriptive study, data were collected from the medical record of patients with diabetic foot ulcers (DFU) who were referred to Dr. Kariadi General Hospital from January 2012 to December 2014. The demographic characteristic, type of foot lesion, etiology, clinical complication, isolated microorganism, treatment, and outcome were reviewed. All the data were analyzed using SPSS version 21.
Results: As much as 3.7% of our hospital diabetic admission was related to foot problems. All patients had type 2 diabetes with no gender predominance. The mean age was 54.3 ± 8.6 years. Most of them had poor diabetes control and disease duration>5 years. Peripheral neuropathy was found in 72.8% and peripheral arterial disease (PAD) associated with 40.6% of cases. Before hospitalization, the ulcers had already developed for 4.7 ± 2.9 weeks. Infection present invariably in nearly all patients, and gram-negative microorganisms were the most common isolates. More than 70% of ulcers were in Wagner grade ≥ 3 and gangrene was already present in 38.5% of cases. A total of 98 (41.5%) lower extremity amputation (LEA) at various level of the foot were carried out. Mortality rate due to DFU reached 10.7%.
Conclusions: A significant number of patients with DFU lead to high LEA rates in our study. Designing a diabetic foot management protocol and initiating a specialized diabetic foot unit of these patients can reduce the associated morbidity and mortality, also improves patient’s overall outcome.