Retrospective evaluation of mortality risk factors in diabetic foot infections

Retrospective Evaluation of Mortality Risk Factors in Diabetic Foot Infections Objective: Diabetes mellitus is a disease that leads to both microvascular and macrovascular complications, resulting in a significant risk of morbidity and mortality. In this study, we aimed to retrospectively evaluate the risk factors for mortality in patients with diabetic foot infections. Method: The data of 399 patients, with a mean age of 60.03±11.56 years, who were followed for diabetic foot infections in the Endocrinology and Metabolism Department of Akdeniz University Hospital, were analyzed. Of these patients, 296 (72.4%) were male. Findings: A total of 399 patients were included in the study, of whom 296 (72.4%) were male, with a mean age of 60.03±11.56 years. The in-hospital mortality rate was 2.5%. Univariate analysis identified the following parameters as significant predictors of in-hospital mortality: bilateral wound site (p=0.002), midfoot infection (p=0.031), entire foot infection (p=0.005), number of complications (p=0.015), major amputation (p=0.013), gram-negative bacterial growth (p=0.001), Acinetobacter baumannii growth (p<0.001), hemoglobin (p<0.001), leukocyte count (p=0.003), ESR (p=0.001), CRP (p=0.001), procalcitonin (p=0.001), and TSH (p=0.013). Multivariate analysis revealed that bilateral wound site (OR: 20.991, 95% CI: 2.596-169.750; p=0.004) and Acinetobacter baumannii growth (OR: 47.823, 95% CI: 5.597-408.655; p<0.001) were independent risk factors for in-hospital mortality. Conclusion: Our findings further demonstrate that mortality in patients with diabetic foot infections occurs primarily in the long term rather than the acute phase. These results may be useful in identifying patients at the highest risk of mortality, who may require prioritization for advanced treatment options. Prevention of the long-term complications of diabetes appears to be the key strategy for reducing long-term mortality rates in this patient population. Key Words: Diabetic Foot Infection, Diabetes Mellitus, Amputation, Osteomyelitis