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Diabetic foot infection incidence decreased by half over 15 years

Issue: October 2014

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WASHINGTON, D.C. — From 1996 to 2010, the incidence of diabetic food infections decreased by more than half, according to data presented at ICAAC 2014.

Bryson Duhon, PharmD, of the University of Texas at Austin, and colleagues conducted a retrospective study of data from the US National Hospital Discharge Surveys from 1996 to 2010. They determined the incidence of principal discharge diagnoses among adults aged 18 and older of foot infections, including gangrene, osteomyelitis, cellulitis/abscess of the foot or toe or paranychia with a secondary diagnosis of diabetes. They also evaluated the number of lower extremity amputations, in-hospital mortality and hospital length of stay.

During the specified time period, there were 1,059,552 discharges for diabetic foot infection. The incidence of these infections decreased from 2.3 infections per 100 diabetes discharges in 1996 to 1.1 infections per 100 diabetes discharges in 2010. The total number of discharges for diabetic foot infection decreased from 86,563 in 1996 to 77,491 in 2010, a decrease of 11%.

The researchers found that 21.6% of the infections throughout the study period resulted in a lower extremity amputation. The proportion of infections leading to amputation decreased from 33.2% in 1996 to 17.1% in 2010. Overall, the all-cause, in-hospital mortality was 1.1% and the median hospital length of stay was 5 days. The leading risk factors for diabetic foot infection included peripheral vascular disease (OR=2.89; 95% 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).

“Enhancement of [preventive] and treatment practices will be essential for continued improvement of outcomes in patients with diabetic foot infection,” the researchers wrote. “These data underscore the importance of directing resources to the prevention of and treatment of diabetic foot infections, as well as developing public policy for continued reduction of the incidence of these infections in US hospitals.”

For more information:

Duhon B. Abstract L-414. Presented at: Interscience Conference of Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.

Disclosure: The researchers report no relevant disclosures.