Huy H Do, Tanita Botha, Eleanor Garnys, Casie Barrette, Hanh H Nguyen
{"title":"Trends in diabetes-related foot disease in a tertiary health service in Australia: a 10-year retrospective study.","authors":"Huy H Do, Tanita Botha, Eleanor Garnys, Casie Barrette, Hanh H Nguyen","doi":"10.1111/imj.70036","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Despite being a major cause of hospitalisations, there is limited literature on the trends in diabetes-related foot disease (DFD) in Victoria, Australia. The aim of this study was to assess the incidence of DFD admissions and outcomes in inpatients with DM at a major Victorian health service.</p><p><strong>Methods: </strong>Inpatients aged >18 years with DM and DFD between 2013 and 2022 were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Admission, demographic and mortality data were extracted from the hospital electronic database. Prevalence and incidence of DM, DFD and amputations were analysed. Independent t tests, Mann-Whitney U tests and χ<sup>2</sup> tests were used to compare groups. Linear regression models were used to explore trends, with logistic and Poisson regression for analysis of 5-year mortality and length of stay.</p><p><strong>Results: </strong>Over 10 years, 37 561 patients with DM required 110 736 admissions at Western Health. DFD prevalence was 17% (n = 6397). An increasing burden of annual DM admissions was observed (6855 to 12 182), with increased rates of DFD admissions (β = 0.480, P < 0.001). Minor amputation rates increased (β = 0.028, P = 0.001), whilst major amputation rates remained stable. DFD cohorts experienced longer admissions (median 4.11 (interquartile range 1.74-9.06) vs 1.83 (interquartile range 0.28-4.50) days, P < 0.001), higher re-admissions (76% vs 47%, P < 0.001) and 5-year mortality (23.4% vs 12.7%, P < 0.001).</p><p><strong>Conclusion: </strong>This large retrospective audit demonstrated an increasing burden of inpatient DM and DFD at Western Health, Victoria in Australia, with greater morbidity and mortality in DFD patients. Health networks need to be prepared for greater health service utilisation required by DFD cohorts, and further funding to prevent DFD is of particular importance to avoid overwhelming health services.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/imj.70036","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aims: Despite being a major cause of hospitalisations, there is limited literature on the trends in diabetes-related foot disease (DFD) in Victoria, Australia. The aim of this study was to assess the incidence of DFD admissions and outcomes in inpatients with DM at a major Victorian health service.
Methods: Inpatients aged >18 years with DM and DFD between 2013 and 2022 were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Admission, demographic and mortality data were extracted from the hospital electronic database. Prevalence and incidence of DM, DFD and amputations were analysed. Independent t tests, Mann-Whitney U tests and χ2 tests were used to compare groups. Linear regression models were used to explore trends, with logistic and Poisson regression for analysis of 5-year mortality and length of stay.
Results: Over 10 years, 37 561 patients with DM required 110 736 admissions at Western Health. DFD prevalence was 17% (n = 6397). An increasing burden of annual DM admissions was observed (6855 to 12 182), with increased rates of DFD admissions (β = 0.480, P < 0.001). Minor amputation rates increased (β = 0.028, P = 0.001), whilst major amputation rates remained stable. DFD cohorts experienced longer admissions (median 4.11 (interquartile range 1.74-9.06) vs 1.83 (interquartile range 0.28-4.50) days, P < 0.001), higher re-admissions (76% vs 47%, P < 0.001) and 5-year mortality (23.4% vs 12.7%, P < 0.001).
Conclusion: This large retrospective audit demonstrated an increasing burden of inpatient DM and DFD at Western Health, Victoria in Australia, with greater morbidity and mortality in DFD patients. Health networks need to be prepared for greater health service utilisation required by DFD cohorts, and further funding to prevent DFD is of particular importance to avoid overwhelming health services.
期刊介绍：
The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.
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