Risk factor analysis on the healing time and infection rate of diabetic foot ulcers in a referral wound care clinic

Khaw Kher Kee, Harikrishna K.R. Nair, Pei Yuen Ng

Research output: Contribution to journalArticle

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Abstract

Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU). Method: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic. Results: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm 2 . Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm 2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm 2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05). Conclusion: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence. Declaration of interest: The authors have no conflict of interest to declare.

Original languageEnglish
Pages (from-to)S4-S13
JournalJournal of Wound Care
Volume28
DOIs
Publication statusPublished - 1 Jan 2019

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Diabetic Foot
Statistical Factor Analysis
Referral and Consultation
Wounds and Injuries
Infection
Ulcer
Blood Glucose
Fasting
Blood Pressure
Conflict of Interest
Amputation
Wound Healing
Retrospective Studies
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Fundamentals and skills
  • Nursing (miscellaneous)

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Risk factor analysis on the healing time and infection rate of diabetic foot ulcers in a referral wound care clinic. / Kee, Khaw Kher; Nair, Harikrishna K.R.; Ng, Pei Yuen.

In: Journal of Wound Care, Vol. 28, 01.01.2019, p. S4-S13.

Research output: Contribution to journalArticle

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abstract = "Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU). Method: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic. Results: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5{\%} presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm 2 . Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95{\%}CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95{\%}CI 1.57 to 7.39), ulcer size ≥10cm 2 (OR: 2.90; 95{\%}CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95{\%}CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm 2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05). Conclusion: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence. Declaration of interest: The authors have no conflict of interest to declare.",
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N2 - Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU). Method: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic. Results: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm 2 . Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm 2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm 2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05). Conclusion: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence. Declaration of interest: The authors have no conflict of interest to declare.

AB - Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU). Method: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic. Results: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm 2 . Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm 2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm 2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05). Conclusion: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence. Declaration of interest: The authors have no conflict of interest to declare.

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