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1. ANALYSIS OF RISK FACTORS FOR
DIABETIC FOOT INFECTIONS
LEADING TO HOSPITAL ADMISSION ,
SEEN IN A TERTIARY DIABETIC
CENTRE.
2. AIM:1)To analyze the risk factors associated with, and leading to
hospital admission for diabetic foot infection.
2)To develop strategies to reduce the incidence of surgeries and
amputations.
METHODS:Consecutive patients admitted for foot-infection in
D.R.C(n=72) during the period from May 06 to July 06 were
included in the study.History in the form of questionnaires, including
mode of injury, previous treatment taken before admission (if
yes,from whom,after how many days of injury) were
analyzed.Biochemical parameters at baseline and at discharge were
tabulated.Wound morphology was compared according to Texas’
Classification.Outcome ,in comparison to various parameters were
analyzed.
3. PROFILE OF PATIENTS:
N 72
Mean Age 57.5(±8.9)yrs
Male:Female 75:25
Type of D.M Type 2
Duration of Diabetes 27.1% <5yrs
12.9% 5-10yrs
60.0% >10yrs
Regularity of diabetic
medications
72.2% Regular
27.8% Irregular
R.B.S(Mean) 298 (±100)Mg%
HbA1c 10.4%(±2.6%)
Neuropathy 98.6%
P.VD 22.2%
5. Duration of infection
before hospital admission
46.5% 1wk-1Mth
34.7% >1Mth
19.4% <1Wk
Medical attention sought
before coming to D.R.C
73.2% Yes
26.8% No
Onset of treatment after
injury
16.7% <24Hrs
76.3% >24Hrs
Treatment was given by: 47.1%(25) Family Physician
52.9%(28) Local Hospital
History of previous foot
infection
44.4% Yes
HISTORY OF PRESENTING FOOT-INFECTION
6. CHARACTERISTIC OF THE WOUNDS
SITE 50% Toes
16% Foot-Mid Foot Planter
11% Heel
SIZE 70.8% 2-5cm
SIDE 45.8% Left
44.4% Right
9.7% Bilateral
DEPTH 50.0% Probing to tendon/capsule
40.3% Probing to bone
9.7% Superficial
ORGANISM
ISOLATED
20.4% E-Coli
18% Enterococci
15.2% Cuagulase Negative
Staphylococci
7.9% Klebsiella
5.6% M.R.S.A
12. DURATION OF DIABETES Vs INTERVENTION
0
10
20
30
40
50
60
Conservative Surgery
< 5 years 6 - 9 years
> 15 years10 - 15 years
Percentageofpatients
Level of Intervention
14. DURATION OF INFECTION Vs INTERVENTION
0
2
4
6
8
10
12
14
16
<1 WK >1WK
AMP TOE
B K AMP
DURATION OF ILLNESS VS INTERVENTION
7.1%
15.1%
12.1%
PercentageofPatients
Duration of Infection
15. PREVIOUS TREATMENT Vs INTERVENTION
0
2
4
6
8
10
12
14
16
18
CON FOREFOOT
AMP
FMLY PHY
HOSP
12.5
16 16.7
8.0
PREVIOUS TREATMENT vs INTERVENTION
PercentageofPatients
Level of Intervention
17. 1)Elderly , long duration of diabetes.high HbA1c levels & patient with diabetic
neuropathy are at particular risk for foot injury and infection.
2)Family physician seems to play an important role in the initial management, who
needs to be made more aware of impending adverse outcome of foot injury in a diabetic
patient.
3)E-Coli is the most frequently isolated organism.
4)Outcome of patient is influenced by
Duration of diabetes
Duration of foot-infection
HbA1c levels
Previous treatment sought
5)Proper intervention leads to reduction of blood sugars at all time of the day.
6)Aggressive education & awareness about foot care, appropriate foot-wear &
importance of seeking of timely medical advise in case of foot injury can reduce the
level of intervention in all group of diabetic patients.
