title: Retrospective cohort study evaluating the incidence of diabetic foot infections among hospitalized adults with diabetes in the United States from 1996-2010.
abstract: BACKGROUND
  The prevalence of diabetes has increased over the last 2 decades; however, the national incidence of diabetic foot infections (DFIs) in the United States is unknown. We sought to determine national trends in DFIs among hospitalized adults in the United States over 15 years.
  
  
  METHODS
  This was a retrospective cohort study of the U.S. National Hospital Discharge Survey from 1996-2010. Adult patients with a principal diagnosis of foot infection and a secondary diagnosis of diabetes were identified using ICD-9-CM codes. Incidence was defined as DFI discharges per 100 diabetes discharges. Independent risk factors for DFI among diabetics were identified using multivariable logistic regression.
  
  
  RESULTS
  These data represent 1,059,552 DFI discharges over the study period. The incidence of DFI decreased from 1996 (2.3 DFIs/100 diabetes discharges) to 2010 (1.1 DFI/100 diabetes discharges). The proportion of patients experiencing lower-extremity amputation declined from 33.2% in 1996 to 17.1% in 2010. Peripheral vascular disease (odds ratio [OR], 2.89; 95% confidence interval [CI], 2.87-2.91), peripheral neuropathy (OR, 2.62; 95% CI, 2.60-2.64), and male sex (OR, 1.67; 95% CI, 1.66-1.68) were the leading risk factors for DFI.
  
  
  CONCLUSIONS
  The incidence of DFI among hospitalized adults in the United States declined by more than half from 1996-2010.
authors.affiliation: Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX; University Health System, San Antonio, TX.
authors.forename: Bryson M
authors.initials: BM
authors.lastname: Duhon
authors.affiliation: Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX; University Health System, San Antonio, TX.
authors.forename: Elizabeth O
authors.initials: EO
authors.lastname: Hand
authors.affiliation: Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Crystal K
authors.initials: CK
authors.lastname: Howell
authors.affiliation: Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX. Electronic address: kdaniels46@utexas.edu.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Reveles
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D017719:Diabetic Foot / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Amputation; Diabetes; Diabetic foot infection; Epidemiology; Mortality