Open AccessDeterminants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study
Author(s) -
Ignatius Ezeani,
Ejiofor Ugwu,
Olufunmilayo Adeleye,
Ibrahim Gezawa,
Innocent Okpe,
Marcelina Enamino
Publication year - 2020
Publication title -
endocrine regulations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 32
eISSN - 1336-0329
pISSN - 1210-0668
DOI - 10.2478/enr-2020-0023
Subject(s) - medicine , diabetic foot ulcer , diabetic foot , amputation , gangrene , diabetes mellitus , osteomyelitis , wound healing , univariate analysis , logistic regression , surgery , anemia , multivariate analysis , endocrinology
Objective. The high amputation rates from diabetic foot ulcer (DFU) in Nigeria and prolonged hospitalization due to poor wound healing is a source of concern. Furthermore, factors that affect wound healing of DFUs have not yet been well studied in Nigeria, whereas knowing these factors could improve DFU outcomes. Therefore, the objective of this study was to determine the factors that are associated with the wound healing in patients hospitalized for DFU. Methods. The Multi-Center Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN) was an observational study involving 336 diabetic patients hospitalized for DFU and managed by a multi-disciplinary team until discharge or death. Demographic, clinical, and biochemical characteristics were documented. Test statistics used were chi square, t-test, univariate, and multivariate logistic regression. The study endpoints were ulcer healing, LEA, duration of hospitalization, and mortality. Here we present data on wound healing. Results. The mean ± SD age was 55.9±12.5 years. Univariate predictors of wound healing were ulcer duration more than 1 month prior to hospitalization (p 1 month (OR 0.109; 95% CI 0.030–0.395), anemia (OR 0.179; 95% CI 0.056–0.571). Conclusion. Presence of osteomyelitis, duration of ulcer greater than 1 month, PAD, Wagner grade 3 or higher, proteinuria, presence of gangrene, anemia, renal impairment, and HbA1c ≥7% were the significant predictors of wound healing in patients hospitalized for DFU. Early identification and prompt attention to these factors in a diabetic foot wound might significantly improve healing and reduce adverse outcomes such as amputation and death.