Factors related to the grade of diabetic foot ulcers among diabetic patients admitted to AUBMC

Abstract

Background: Diabetic foot ulcers are a significant complication of Diabetes Mellitus (DM) and often result in lower-extremity amputations. Today, diabetic foot complications are contributing to both mortality and morbidity among the diabetic population resulting in considerable physical, physiological and financial burden for the patients and their communities. It has been estimated that the Middle East and North Africa (MENA) region, in addition to the Gulf Cooperation Council (GCC), will have the second highest increase in percentage of people with DM by 2030, as compared to other parts of the world. More specifically, DM affects almost 13percent of the Lebanese population over 25 years of age and therefore, it has become a significant source of morbidity and mortality risk among diabetic patients in Lebanon. Objective: This study aims at investigating the association between social, economic and health-related factors associated with diabetic foot ulcer severity. Methodology: A secondary analysis of a cross-sectional study of 278 diabetic patients admitted with diabetic foot ulcer at the American University of Beirut Medical Center (AUBMC). The investigated predictors included socio demographic variables (age, weight, gender, etc.), patients health history (type of Diabetes, smoking status, hypertension, chronic kidney disease, etc.), and lab values (HbA1c, HDL, BUN, SGOT, etc.). Association between different covariates and the outcome of DFU severity was studied in an ordinal approach using cumulative logit models with proportional odds property. Statistical analysis was performed using SPSS version 24 and STATA version 13. Results The mean age of patients was 66 years. Male represented 70percent of the study population. Majority of patients (73percent) were non-smokers at the time of the study. Out of the 278 patients, 98percent had Type II Diabetes, 63percent had DM for more than 10 years, 20percent had past DFU on a different site than the current one, 81percent were hypertensive, 66percent were dyslipidemic, 30percent had chronic kidney disease, 43percent had C