title: Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital.
abstract: BACKGROUND
  The objective was to determine the risk factors, ulcer grade, and management outcome of patients with diabetic foot ulcers (DFU) managed in a tropical tertiary hospital.
  
  
  METHODS
  This is a prospective observational study of all consecutive diabetes mellitus (DM) patients with DFU admitted in the University of Benin Teaching Hospital, Benin City, Nigeria over a 26-month period. Data documented included age, gender, type of DM, duration of DM, risk factors of DFU, duration of DFU, Wagner's ulcer grade, and the blood glucose at presentation and management outcome.
  
  
  RESULTS
  Thirty-four (55.7%) of the 61 study subjects were females. Their mean age was 56.29±12.71 years. 85.2% had type 2 DM. 13.1% of the patients were newly diagnosed diabetic at presentation. The mean duration of DM was 7.8±6.98 years. The mean duration of DFU was 46.09±47.82 days and the casual blood glucose level at presentation was 18.41±9.31mmol/l. Risk factors of DFU included spontaneous blisters (52.46%), peripheral vascular disease (44.3%), peripheral neuropathy (42.6%), and visual impairment (21.3%). The common ulcer grades were IV (44.3%) and III (36.1%).The amputation rate was 52.2% while the mortality rate was 14.3%.The baseline ulcer grade was significantly associated with the risk of lower extremity amputation, and the odds ratio was 2.36 (95% 1.06-5.21).
  
  
  CONCLUSIONS
  Spontaneous blisters, peripheral vascular disease, peripheral neuropathy,and visual impairment are common risk factors of DFUs. Many of our patients with DFUs presented with grade IV and V ulcers with the resultant high rate of lower extremity amputations (LEAs). Early presentation and treatment of DFUs will reduce LEAs.
authors: Department of Medicine, University of Benin, Teaching Hospital, PMB 1111, Benin City, Edo State, Nigeria.
authors: Andrew E
authors: AE
authors: Edo
authors: Gloria O
authors: GO
authors: Edo
authors: Ignatius U
authors: IU
authors: Ezeani
keywords: Diabetic foot ulcer; Wagner's grading; lower extremity amputation
references: Int Wound J. 2009 Oct;6(5):381-5
references: 19912395
references: Int J Low Extrem Wounds. 2008 Jun;7(2):93-8
references: 18492676
references: Med J Malaysia. 2000 Jun;55(2):236-41
references: 19839152
references: Foot Ankle. 1981 Sep;2(2):64-122
references: 7319435
references: Lancet. 1998 Sep 12;352(9131):837-53
references: 9742976
references: East Afr Med J. 2003 Jan;80(1):36-43
references: 12755240
references: Eur J Intern Med. 2010 Apr;21(2):91-6
references: 20206878
references: J Foot Ankle Surg. 1997 Mar-Apr;36(2):146-50
references: 9127220
references: Diabetes Res Clin Pract. 2006 Mar;71(3):272-9
references: 16139385
references: Diabetes Res Clin Pract. 2007 Feb;75(2):148-52
references: 16824638
references: Burns. 2000 Feb;26(1):102-5
references: 10630327
references: MMWR Morb Mortal Wkly Rep. 2011 Nov 18;60(45):1549-53
references: 22089967
references: Arch Intern Med. 1992 Mar;152(3):610-6
references: 1546925
references: Prim Care Diabetes. 2009 Nov;3(4):219-24
references: 19783493
references: Tohoku J Exp Med. 1983 Dec;141 Suppl:575-82
references: 6680534
references: West Afr J Med. 1990 Jan-Mar;9(1):1-5
references: 2271417
references: Diabetologia. 2010 May;53(5):840-9
references: 20127309
references: Trop Geogr Med. 1990 Jan;42(1):83-6
references: 2148040