Background
Methods
The Study Population and Source Data
Identification of ICD-9 codes for diabetic foot infections
Use of ICD-9-CM codes to classify diabetic foot infections
Characteristics and treatment of patients with diabetic foot infections
Treatment during first identified hospitalization for foot infection
Outcomes of patients with diabetic foot infections
Rehospitalization for foot infection
Long-term outcomes
Statistical analyses
Results
Counts and classification of patients with diabetic foot infections
Proportions of patients with co-existing infections
Group | ||||||
---|---|---|---|---|---|---|
Coexisting infections | Gangrene | Osteomyelitis | Ulcer | Foot Cellulitis or Abscess | Toe Cellulitis or Abscess | Paronychia |
11,666 | 4,133 | 20,142 | 4,438 | 1,395 | 289 | |
Gangrene
| - | - | - | - | - | - |
Osteomyelitis
| < 1% | - | - | - | - | - |
Ulcer
| 17.2% | 25.0% | - | - | - | - |
Foot cellulitis/abscess
| 16.0% | 23.5% | 17.6% | - | - | - |
Toe cellulitis/abscess
| < 1% | 11.6% | < 1% | < 1% | - | - |
Paronychia
| < 1% | < 1% | < 1% | < 1% | < 1% | - |
Demographics, diabetic complications, and other co-morbidities of patients with different types of infection
Group | ||||||||
---|---|---|---|---|---|---|---|---|
Any | Gangrene | Osteomyelitis | Ulcer | Foot Cellulites or Abscess | Toe Cellulitis or Abscess | Paronychia | Other | |
61,007 | 11,666 | 4,133 | 20,142 | 4,438 | 1,395 | 289 | 18,944 | |
Male | 98.5% | 99.1% | 98.9% | 98.6% | 98.4% | 98.4% | 96.9% | 98.0% |
Mean Age | 68.1 | 70.0 | 66.3 | 68.7 | 66.9 | 67.3 | 66.7 | 66.9 |
Standard deviation | 11.0 | 10.2 | 11.0 | 10.9 | 11.4 | 11.4 | 12.6 | 11.3 |
White | 76.3% | 68.0% | 75.1% | 77.9% | 76.6% | 81.1% | 76.6% | 79.7% |
African-American | 16.0% |
23.1%
|
17.5%
|
15.7%
|
14.3%
|
12.0%
| 17.4% | 12.1% |
Other race | 7.7% | 8.9% | 7.4% | 6.4% | 9.1% | 6.9% | 6.0% | 8.2% |
Unknown | 3.5% | 3.1% | 6.2% | 3.1% | 2.9% | 3.3% | 2.4% | 3.7% |
Peripheral vascular disease | 66.9% |
77.2%
| 71.5% | 73.8% | 58.4% | 64.6% | 55.7% | 54.6% |
Peripheral neuropathy | 53.4% | 55.6% |
62.7%
|
59.9%
| 55.5% | 58.1% | 49.5% | 42.5% |
Diabetic eye disease | 43.2% | 48.9% | 48.7% | 47.3% | 41.4% | 46.5% | 34.3% | 34.2% |
Cerebrovascular diseases | 24.3% | 29.2% |
19.2%
| 26.1% | 21.2% | 24.7% | 27.7% | 21.0% |
Myocardial infarction | 22.5% | 24.0% |
17.0%
| 22.7% | 20.5% | 22.2% | 23.5% | 23.0% |
Renal diseases | 20.6% | 26.2% | 16.9% | 22.1% | 17.0% | 18.5% | 19.4% | 17.5% |
Length of hospital stay and treatments received
Group | |||||||
---|---|---|---|---|---|---|---|
Gangrene | Osteomyelitis | Ulcer | Foot Cellulitis or Abscess | Toe Cellulitis or Abscess | Paronychia | Other | |
11,666 | 4,133 | 20,142 | 4,438 | 1,395 | 289 | 18,944 | |
Length of stay (days)
| |||||||
Median |
14
|
10
|
7
|
6
|
5
| 6 | 6 |
Mean(SD) | 31.1 (61.6) | 28.5 (62.5) | 20.0 (62.5) | 12.6 (34.9) | 15.2 (86.6) | 27.8 (96.5) | 13.9 (44.4) |
Diagnostic studies
| |||||||
Arteriogram leg |
12.7%
| 4.1% | 5.8% | 2.4% | 3.3% | 2.1% | 1.6% |
Aortogram |
7.8%
| 2.6% | 3.7% | 1.6% | 2.5% | < 1% | 1.2% |
Treatments
| |||||||
Any current amputation |
1.9%
|
1.5%
|
0.3%
|
0.3%
|
0.7%
|
0.0%
| 0.2% |
Any past amputation |
11.0%
|
5.7%
|
4.2%
|
2.0%
|
2.0%
|
1.4%
| 1.7% |
Excisional debridement | 3.5% |
5.4%
| 3.8% | 2.0% | 2.1% | 1.4% | 1.0% |
Skin/subcutaneous I & D | 1.2% | 2.5% | 1.6% |
3.9%
|
3.8%
| 2.8% | 3.0% |
Outcomes at 1 year
| |||||||
Amputations |
18.8%
|
10.0%
|
7.7%
|
4.2%
|
5.4%
|
1.7%
| 1.8% |
Long-term care |
16.5%
|
14.6%
|
11.1%
|
10.5%
|
8.2%
|
7.9%
| 8.6% |
Death |
24.4%
|
12.5%
|
19.3%
|
11.5%
|
12.0%
|
14.9%
| 13.2% |