Time to Development of Diabetic Foot Ulcer and It’s Predictors Among Diabetic Mellitus Patients At Jimma University Medical Center

Abstract

Introduction:Diabetic foot ulcer are common problems in diabetes and the leading cause of prolonged hospital admission, health-related costs, and reduced quality of life for diabetes patients.The general objective of this study was to assess time to development of diabetic foot ulcer and it’s predictors among diabetes mellitus patients by using coxPH model in the case of Jimma University Medical Center, Jimma, Ethiopia. Methodology: A retrospective study design was employed to collect the relevant information from the medical records of diabetic patients from March 20, 2018, up to march 1 2023 at Jimma University Medical Center.The Kaplan-Meier method was used to estimate the survival time and Cox’s regression model was employed to identify the covariates that statistically significant factors for development of foot ulcers with the help of R software’s to analyse the data. Results: A total of 703 diabetics patients were included in this study, of which 241(34.3%) patients developed foot ulcer during the study period, with a minimum and maximum development times of 32 and 53 months,respectively.The overall median development time was 35 months with (34, 37) 95% confidence interval.From multivariate Cox regression model analysis patients whose had Overweight[HR=2.8568,CI:(1.42,5.76)], Obesity[HR=2.6723;CI:(1.11,6.46)],Peripheral neuropathy [HR=2.1197;CI:(1.23,3.66)],Chronic kidney[HR= 1.52;CI:(1.002,2.31)],Alcohol intake[HR=1.6975; CI:(1.16,2.49)], Hypertension[HR=2.12; CI:(1.18,3.81)], Vascular disease[HR=1.7143; CI:(1.22,1.7)], Smoking[HR=1.3133; CI:(1.1,1.71) ] were statistically associated with development diabetic foot ulcer. Conclusion:Multivariate Cox regression analysis showed that, BMI,peripheral neuropathy,hypertension, Smoking,Vascular disease,Alcohol,Kidney were the significat factors related to development time of diabetic foot ulcers.Based on study results,it is recommended that diabetic patients with Peripheral neuropathy have high risk for development of foot ulcers,so patients should have to control their life style inorder to prevent foot ulcers.