Outcomes of hospitalized diabetic foot patients in a multi-disciplinary team setting: Thailand's experience

AbstractAimsThe aims of this study were to evaluate the outcomes of treatment among hospitalized patients with diabetic foot ulcers, the risk factors for non-healing ulcers, and the rate of major amputation among Thai patients.MethodsA retrospective study of hospitalized diabetic foot patients treated at Theptarin Hospital during the period of 2009–2013. The complete healing rate was assessed at 12 months after admission.ResultsDuring the study period, 232 patients (123 males and 109 females) with 262 admissions were included (mean age 65.6 ± 11.9 years, mean duration of diabetes 17.2 ± 9.9 years) with a mean follow-up of 17.5 ± 16.7 months. Major amputations were performed in 4.2% of the patients and peripheral vascular disease (PVD) was a predictive factor (OR 5.25; 95% CI [1.43–19.29]; p-value 0.006). Complete healing (including minor amputations) was achieved in 82.1% of the admissions. Only DFU of the heel was a statistically significant (OR 3.34; 95% CI [1.11–10.24]; p-value 0.041) predictor of non-healing ulcers. Three patients (1.1%) died during hospitalization.ConclusionsManagement of diabetes-related foot ulcers with a multidisciplinary approach resulted in a limb salvage rate that was greater than 90% and a complete healing rate that was greater than 80%. Successful management of diabetic foot ulcers might be possible in Thailand utilizing this approach