Arisvia Sukma Hariftyani, - and Hermina Novida, - and Mouli Edward, - (2021) Profile of Diabetic Foot Ulcer Patients at Tertiary Care Hospital in Surabaya, Indonesia. Jurnal Berkala Epidemiologi, 9 (3). pp. 293-302. ISSN 2541-092X

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Abstract

Background: Diabetic Foot Ulcer (DFU) has been associated with a high mortality rate of Diabetes Mellitus (DM) patients. Both behavioral and biological factors cause predisposition to DFU. Purpose: This research describes the profile of hospitalized DFU patients at a tertiary care hospital in Surabaya. Methods: A retrospective descriptive study that analyzed medical records of hospitalized T2DM patients with DFU in Dr. Soetomo General Hospital. Sampled respondents were patients ≥ 21 years old who were hospitalized between 2016–2018. Demographic data, clinical characteristics, medical histories, length of hospital stay, laboratory results, precipitating factors, microorganism culture results, treatment, and outcome were analyzed. Descriptive analysis is presented in the form of narratives, tables, and diagrams. Results: 9.08% of hospitalized Type 2 DM (T2DM) cases were related to foot ulcers. The average patient age was 57.00 ± 9.83 years with no gender predominance. DM was poorly controlled (Mean HbA1C 9.78±2.83%; RBG 251.83 ± 158.15 mg/dL). The majority of patients had sepsis (68.26%) and renal function impairment (62.72%). Ulcers with Wagner grades of 4–5 were frequent (41.31%). The highest percentage of sepsis (80.49%) and the average leukocyte level (22.60±11.95 x10 9 /L) were found in gangrenous feet. Anemia was more predominant and severe in ulcers with higher Wagner grades. Trauma and Escherichia coli were the most common precipitating factors and microorganisms isolated, respectively. Amputation was performed for 82.36% of patients who were admitted to hospital with gangrene. The Lower Extremity Amputation (LEA) and mortality rates were 14.11% and 40.93%, respectively. Conclusion: DFUs were found to have a relatively high prevalence among T2DM patients, and Latar Belakang: Diabetic Foot Ulcer (DFU) dikaitkan dengan tingkat kematian pasien Diabetes Melitus (DM) yang tinggi. Faktor perilaku dan biologis merupakan predisposisi terjadinya DFU. Tujuan: Penelitian ini untuk mendeskripsikan profil pasien DFU yang dirawat di Rumah Sakit Perawatan Tersier di Surabaya. Metode: Sebuah studi deskriptif retrospektif menggunakan rekam medis pasien DMT2 yang dirawat di rumah sakit dengan DFU di RSUD Dr. Soetomo. Sampel merupakan pasien berusia ≥ 21 tahun yang dirawat antara tahun 2016-2018. Data demografis, karakteristik klinis, riwayat medis, durasi dirawat di rumah sakit, hasil laboratorium, faktor pencetus ulkus, hasil kultur mikroorganisme, pengobatan, dan outcome dianalisis. Analisis deskriptif disajikan dalam narasi, tabel, dan diagram. Hasil: 9.08% kasus DMT2 yang dirawat di rumah sakit dari tahun 2016-2018 terkait dengan ulkus kaki. Usia rata-rata adalah 57.00 ± 9,83 tahun tanpa dominasi gender. Pasien memiliki pengendalian DM yang buruk (Mean HbA1C 9,78 ± 2,83%; RBG 251,83 ± 158,15 mg/dL). Mayoritas pasien mengalami sepsis (68,26%) dan gangguan fungsi ginjal (62,72%) Ulkus berderajat wagner 4-5 mendominasi pasien. Persentase sepsis tertinggi (80,49%) dan rata-rata kadar leukosit (22,60 ± 11,95 x 10 9 / L) didapatkan pada pasien kaki gangren. Anemia lebih dominan dan berat pada ulkus dengan derajat wagner lebih tinggi. Trauma dan Escherichia coli adalah faktor pencetus ulkus dan mikroorganisme terisolasi paling umum. 82,36% dari amputasi dilakukan pada pasien yang datang ke rumah sakit dengan gangren. Tingkat amputasi ekstremitas bawah dan kematian masing-masing adalah 14,11% dan 40,93%. Kesimpulan: DFU memiliki prevalensi yang relatif tinggi di antara pasien DMT2 dan tidak dapat diabaikan karena tingkat kematian mereka yang tinggi.

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