Nationwide prevalence and clinical characteristics of inpatient diabetic foot complications: A Peruvian multicenter study

Abstract

Objective: To evaluate the burden of diabetic foot complications amongst inpatients in Peru.

Materials and methods: Cross-sectional multicenter study, performed in public hospitals, in one-day enrollment between October and December 2018.

Results: We included 8346 patients from 39 national hospitals. Diabetic foot (DF) inpatient point prevalence was 2.8% (CI 95% 2.4-3.1), and DF point prevalence among Diabetes Mellitus (DM) inpatients was 18.9% (CI 95% 16.7-21.1). DF prevalence was higher in jungle and coastal hospitals than highlands ones, and there was no difference according to its care complexity level. Of the 234 patients with DF, 73% were males, age average was 62 ± 12 years, with DM mean time duration of 15 ± 9.9 years. Regarding to DF etiology, 91% and 68% had some degree of peripheral neuropathy and peripheral artery disease, respectively. According to the Infectious Diseases Society of America criteria, 61% presented moderate to severe infections, and 40% had bone involvement. Debridement within 48 h was performed in 36% of sepsis cases.

Conclusion: Peru has a substantial burden of DF disease, with a greater share of that burden falling on less equipped hospitals in the country's jungle and coastal regions. Interdisciplinary teams and pathways may improve the time of surgical debridement in the highest risk patients.

Keywords: Diabetic foot; Diabetic foot ulcer; Epidemiology; Inpatients; Peru; Prevalence; Rural.