Clinical Burden of Diabetic Foot Ulcers Among Jordanian Patients with Diabetes: A 11-Year Retrospective Cohort Study.

Abstract

Background: Peripheral neuropathy is among the complications associated with diabetes and is often accompanied by numbness, which can cause tissue damage and lead to the formation of diabetic foot ulcers (DFUs). This research aimed to investigate the prevalence and clinical outcomes of DFU among diabetic patients in Jordan.

Methods: A retrospective longitudinal cohort study was conducted between January 2013 and December 2023. All patients with DFU attending the University of Jordan Hospital and above 18 years of age were retrospectively followed up for at least one year. Mortality rates were considered as secondary outcomes.

Results: A total of 3131 DFU patients were identified, with 1648 inpatients and 1483 outpatients. Overall, the cumulative percentage of the prevalence of DFU during the 11 years was 6.57%. DFUs were found to have increased the length of stay in hospitals (mean = 9.46 days), a high number of complicated cases of ulcers with infections: Inpatient (37.2%), outpatient (25.3%); and significant amputations: minor amputations (20.4%), major amputations (12.4%). The prevalence of infected ulcers among DFU patients was 12.2%. The mean survival time was 70.4 days (±3.3), with a 95% confidence interval of 64.0 to 76.9 days. The number of conditions, including gangrene, myocardial infarction, kidney disease, retinopathy, and neuropathy, were marginally linked to increased mortality risks.

Conclusion: Despite the progress that has been achieved in the management and treatment of diabetes, the frequent hospitalizations, infections, and limb amputations that occur as a result of DFUs underscore the importance of effective management and prevention of the disease.