THE EPIDEMIOLOGY OF HIGH-RISK DIABETIC FOOT AND CLINICAL OUTCOME OF DIABETIC FOOT CLINIC AT NAN HOSPITAL

Abstract

BACKGROUND: Diabetes is one of the non-communicable diseases associated with many diabetes complications. The diabetic foot is one of the major complications of diabetic patients which is severe and results in the patient getting a foot or leg amputated. Therefore, an epidemiological study of high-risk diabetic foot patients in Nan Province was conducted to obtain data for planning and developing a treatment system in high-risk diabetic foot patients in Nan Province.
OBJECTIVE: To study the epidemiology and characteristics of high-risk diabetic foot patients and clinical outcomes for high-risk diabetic foot patients in Nan hospital.
METHODS: This research was a retrospective descriptive study. Recruit patients with high-risk diabetic feet by searching patient data from electronic medical records from October 1, 2018, to June 30, 2022, by searching for ICD-10 diabetes and ICD-10 amputation codes. The patient must have sufficient information for investigation and not be amputated for reasons unrelated to diabetes. The baseline data of patients and treatment data in the diabetic foot clinic of Nan Hospital were collected. Data were presented with descriptive statistics for quality data by number (%), and quantitative data with the mean ± standard deviation (SD).
RESULTS: A total of 54 high-risk diabetic foot patients was found, with a mean age of 60±11.30 years. Most of the patients were male (64.80%), had type 2 diabetes (96.30%), and comorbid diseases (87.04%) e.g. hypertension (59.30%), chronic renal failure (44.40%), and 4 patients died from diabetic wound infection. Forty-four patients also had their feet or legs amputated. Almost all amputation causes were wound infections (95.50%). The amputation level was at the toe (45.50%), below knee amputation (29.50%), and partial foot amputation (20.50%). Only 34 patients were registered at a diabetic foot clinic, with the chief complaints were below the knee and above knee amputation (44.10%) and had a wound (29.40%). During the follow-up of patients at the diabetic foot clinic, 90% of patients had the wound healed and no patients had repeated amputations of their feet or legs.
CONCLUSIONS AND RECOMMENDATIONS: High-risk diabetic foot patients in Nan Province had high disease severity. This study found the patient died from an infected ulcer, leg or foot amputated. However, the ability to access diabetic foot clinics for patients is still limited. Therefore, the hospital or healthcare system should be developing an educating system to patients on foot care, screening system for diabetic foot, a referral system to the diabetic foot clinic and improved ability of the diabetic foot clinic.