Clinical Outcomes of Patients Hospitalized With Diabetic Foot Ulcer at a Tertiary Hospital in Ethiopia: A 5‐Year Retrospective Audit

ABSTRACT

Diabetic foot ulcer is a major cause of hospitalization and lower extremity amputation, particularly in low‐resource settings where patients frequently present with advanced wound. This study assessed the clinical outcomes of patients admitted with diabetic foot ulcer. We conducted a retrospective study of patients admitted to a public hospital in Ethiopia with diabetic foot ulcer. The primary outcome was lower‐extremity amputation. Descriptive analyses, bivariate comparisons, and logistic regression were performed. A total of 146 patients hospitalized with diabetic foot ulcer were included. The mean (±SD) age was 59.4 (±11.7) years. Most patients presented with advanced disease: 86.3% had Wagner grade ≥ 3% and 60.3% had Texas stage C/D. Overall, 53.4% underwent lower‐extremity amputation. Factors associated with higher odds of amputation were: long standing diabetes (duration ≥ 10 years: Adjusted Odds Ratio: 2.42; [95% Confidence Interval: 1.01–5.80]), longer ulcer duration (every day of delayed presentation: 1.02 [1.01–1.03]), previous foot ulcer (4.34 [1.55–12.13]), advanced ulcer stages with University of Texas stage C or D (2.86 [1.19–6.90]). Hospitalized diabetic foot ulcer patients presented with advanced disease and experienced a very high lower‐extremity amputation burden. This high in‐hospital amputation rate in a low‐income country highlights the profound disparity in preventive and limb‐saving diabetic foot interventions.