scholarly journals Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer

2019 ◽  
Vol 47 (2) ◽  
pp. 3-16
Author(s):  
Patrianef Darwis ◽  
Bakti H Simanjuntak ◽  
Grace Wangge ◽  
Deddy Pratama ◽  
Ahmad Bakri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Smoking History ◽  
Ulcer Size

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition. Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis. Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p < 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p < 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p < 0.001, OR 8.360, CI 95 % 3.209 – 21.780). Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer. Keywords: Diabetic foot ulcer, Length of stay

scholarly journals THE EFFECT OF INFRARED RAY AND COUNSELING ON DIABETIC FOOT ULCER HEALING PROCESS

2019 ◽  
Vol 8 (2) ◽  
pp. 134-139
Author(s):  
Mokh Sujarwadi ◽  
Mukhammad Toha ◽  
Nurul Huda
Keyword(s):  
Diabetes Mellitus ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Capillary Refill Time ◽  
Capillary Refill ◽  
Significance Level

Background: Diabetic foot ulcer is one of the chronic complications of diabetes mellitus caused by neuropathy, angiopathy and decreased endurance. The risk of amputation in patient with diabetes mellitus fifteen times greater compared to non-diabetic. Various efforts on diabetic foot wound care have been carried out but the results are still far from satisfactory. Until now, infrared and counseling effect on wound healing in diabetic foot cannot be explained.Objective: The purpose of this study was to examine the effect of infrared ray and counseling on diabetic foot ulcer healing process.Method: The research design was quasi-experimental design with posttest control group design, the population in this study were patients with grade 3 diabetic foot wounds, blood sugar 100-200 g/ dl, BMI 18.5 to 24.9, aged 35-55 years. Large sample in this study as many as 20 were divided into two groups, the control random sampling. The collection of data for the dependent variable using the observation sheet after the tenth day of treatment, which consists of the rate of growth of granulation, ankle brachial index and capillary refill time. Furthermore, the data were processed using non-parametric statistical significance level < 0.05.Result: The results showed that the infrared and counseling effect on the growth of granulation with a significance level (p = 0.0003), infrared and counseling influence ankle brachial index (p = 0.024), infrared and counseling effect on capillary and counseling effect on capillary refill time (p = 0.024).Conclusion: It can be concluded from this study that applying infrared and counseling has any impact on healing in diabetic foot ulcer, on the growth of granulation and improved blood in diabetic foot ulcers. Key words: Infrared Ray, Counseling, Foot Ulcer Healing.

scholarly journals Correlation between Serum Level of Vitamin D and Severity Degree of Diabetic Foot Ulcer in Patients with Normal Ankle Brachial Index

2019 ◽  
Vol 1 (1) ◽  
pp. 34-36
Author(s):  
Saleh Harris ◽  
Raden Suhartono ◽  
Aria Kekalih
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Serum Level ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
Severity Degree

Introduction: Diabetes mellitus can cause various complications, including diabetic foot ulcers (DFU). Vitamin D levels are known to be correlated with wound healing and insulin resistance. Method: This cross-sectional study aimed to determine the correlation between the serum level of vitamin D and the severity degree of DFU. Thirty DFU patients with normal ankle- brachial index, grouped into degrees according to the Wagner classification, were included in this study. Their serum level of vitamin D was examined using the chemiluminescent immunoassay method. The correlation between these two variables was analyzed. Results: Patients were 18 males (60%) and 12 females (40%) with an average age of 57 years. The average serum level of vitamin D was 10.58 ng/mL. A significant correlation was found between the serum level of vitamin D and the severity of DFU (r= -0.901, p <0.001). Conclusion: The serum level of vitamin D screening in DFU patients was strongly correlated with the degree of DFU. Keywords: diabetes mellitus, diabetic foot ulcer, vitamin D, Wagner classification

scholarly journals A multi centric study of diabetic foot ulcer: causes and complications

2019 ◽  
Vol 6 (4) ◽  
pp. 1327 ◽  
Author(s):  
Earnest Daniel Prasad Pilla ◽  
Rajendra Desai ◽  
Prashant Ramdas Kokiwar
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Ulcer Formation ◽  
Index Test ◽  
Ischemic Ulcer ◽  
Plantar Aspect ◽  
The Right

Background: Diabetes mellitus is a metabolic disorder and has become an epidemic. 73 million people in India have diabetes mellitus. Presently India has ranked the second highest country with diabetics in the world. Diabetic foot ulcer is a result of one or both of the complications of diabetes such as neuropathy and ischemia. The objective of the study was to study the causes for the ulcer formation on the toes.Methods: A prospective study was carried out from January 2016 to August 2018 from multiple diabetic clinics in Hyderabad, India. All the patients had undergone the following tests. 1) X-ray foot, 2) ABI (ankle brachial index) test, 3) Neuropathy test by VPT (vibration perception test) and monofilament.Results: The age of the patients mostly ranged from 50 to 70 years. 61% of the patients had neuropathic ulcer, 20% had ischemic ulcer, 19% had neuro-ischemic ulcer. 69% of these patients had osteomyelitis. 52% had ulcer on the right foot and 48% on the left. 15% had dry gangrene with ulcer where as 85% had infected ulcers. 60% of the ulcers were only on the plantar aspect and 24% had ulcers all around the toe. ABI (ankle brachial index) was normal 0.9 to 1.2 in 80% of patients whereas 20% had abnormal (<0.9). 60% of patients had ulcers involving the 1st and 2nd toes and both feet were almost equally affected.Conclusions: Neuropathy is the leading cause for ulcers on the toes followed by ischemia and then infection. Treating the neuropathic ulcer early can bring down the amputation rate of the toes by 50%.

Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

2020 ◽  
Vol 16 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Mutasem Ababneh ◽  
Mousab Y. Al Ayed ◽  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish
Keyword(s):  
Diabetic Foot ◽  
Statistical Significance ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Screening Tests ◽  
Cross Sectional ◽  
Toe Brachial Index

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

scholarly journals A Pilot Randomized, Controlled Study of Nanocrystalline Silver, Manuka Honey, and Conventional Dressing in Healing Diabetic Foot Ulcer

2017 ◽  
Vol 2017 ◽  
pp. 1-15 ◽  
Author(s):  
Ka-Kit Tsang ◽  
Enid Wai-Yung Kwong ◽  
Tony Shing-Shun To ◽  
Joanne Wai-Yee Chung ◽  
Thomas Kwok-Shing Wong
Keyword(s):  
Ulcer Healing ◽  
Diabetic Foot ◽  
Reduction Rate ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Size Reduction ◽  
Controlled Study ◽  
Manuka Honey ◽  
Ulcer Size ◽  
Randomized Controlled

Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU). This study was an open-label randomized controlled trial with three parallel groups’ design in examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation. 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled. Wound cleaning, debridement, and topical dressing application were performed according to the group allocation in each visit at weeks 1, 2, 3, 4, 6, 8, 10, and 12. The results found that the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%). In bacteriology, nAg showed a greater rate of microorganism reduction although it was not significant. To conclude, nAg alginate was potentially superior to MH and conventional dressing in healing diabetic foot ulcer in terms of ulcer size reduction rate.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

Risk for Contrast-Induced Nephropathy in Elderly Trauma Patients

2012 ◽  
Vol 78 (10) ◽  
pp. 1114-1117 ◽  
Author(s):  
Ryan Finigan ◽  
Jacqueline Pham ◽  
Rosemarie Mendoza ◽  
Michael Lekawa ◽  
Matthew Dolich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Injury Severity ◽  
Unit Length ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Contrast Induced Nephropathy ◽  
History Of ◽  
Elderly Trauma Patients

The objective of this study was to determine if elderly trauma patients are at risk for contrast-induced nephropathy (CIN). A retrospective study was conducted identifying 362 patients 65 years and older in our Level I trauma center who received computerized tomography (CT) scans with intravenous contrast. CIN was defined as a 25 per cent increase in serum creatinine levels or a 0.5 mg/dL increase above baseline after CT. History of diabetes mellitus, hospital length of stay, intensive care unit length of stay, Injury Severity Score (ISS), and age were recorded. Eighteen per cent (21 of 118) of the patients had a peak in creatinine, 12 per cent (14 of 118) peaked and returned to baseline, and 6 per cent (7 of 118) peaked and stayed high. Pre-CT elevated creatinine, diabetes mellitus, increased hospital length of stay, ISS, and age show little association to CIN. The data suggest that CIN in elderly trauma patients is rare, regardless of history of diabetes mellitus, age, creatinine, high ISS, or result in higher length of stay. Therefore, there is little justification for the delay in diagnosis to assess a patient's renal susceptibility.

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