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

• Main Authors: Yotsapon Thewjitcharoen, MD, Sirinate Krittiyawong, MD, Sriurai Porramatikul, MD, Wyn Parksook, MD, Lapakorn Chatapat, MD, Orawan Watchareejirachot, RN, Jeeraphan Sripatpong, PT, Thep Himathongkam, MD, FACP, FACE
• Format: Article
• Language: English
• Published: Elsevier 2014-12-01
• Series: Journal of Clinical & Translational Endocrinology
• Subjects: Diabetic foot ulcers; Hospitalized; Thailand
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214623714000398

Aims: The 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. Methods: A 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. Results: During 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. Conclusions: Management 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.