Diabetic foot infections in internal medicine services in Spain (2018-2022).

Abstract

Introduction: Diabetic foot infections represent a common and serious complication of diabetes mellitus, with a wide range of clinical presentations. Despite their significance, uncertainties persist regarding their management and impact on Internal Medicine services.

Materials and methods: A retrospective cohort study was conducted using data from the Registry of Specialized Healthcare Activity (RAE-CMBD) over a five-year period (2018-22). Patients discharged from Internal Medicine with a diagnosis of diabetic foot were included. Demographic, clinical, and activity data were collected, and the cumulative incidence of diabetic foot, in-hospital mortality, need for amputation, and associated costs of hospitalization were analyzed.

Results: 15,402 episodes with a diagnosis of diabetic foot were identified, representing 0.41% of Internal Medicine, which implies an age-adjusted incidence rate of between 2 and 3 cases per 1000 admissions in these services. These patients had a high in-hospital mortality rate (16%) and a significant percentage required amputation (8.25%). Advanced age, the presence of comorbidities, and complications during admission were associated with a higher risk of mortality and amputation. The average cost per admission is over €6000.

Conclusions: Diabetic foot is a pathology with a high impact on Internal Medicine services, both due to the volume of activity and the high mortality and cost generated by this condition.