Few studies have investigated foot ulcers in representative inpatient populations. The aim of this point-prevalence study was to investigate the prevalence and independent factors associated with diabetes-related and non-diabetes-related foot ulcers in a large representative inpatient population.
This study was a secondary analysis of data from the Foot Disease in Inpatients Study, a multi-site point-prevalence study of 733 representative Australian inpatients. Self-reported demographic, social determinant, medical history, foot disease history, self-care ability and footwear variables were obtained from all participants. Clinically-diagnosed foot ulcers, foot infection, peripheral arterial disease (PAD), peripheral neuropathy (PN) and foot deformity were also obtained from all participants. Multivariate logistic regression was used to identify independent factors associated with foot ulcers in diabetes and non-diabetes inpatient subgroups.
Of the 733 inpatients, 23.5% had diabetes (mean(SD) age 65(17), 59.3% male) and 76.5% did not have diabetes (mean(SD) age 61(19), 54.7% male). The overall foot ulcer prevalence was 6.7%; made up of 3.6% diabetes-related and 3.1% non-diabetes-related foot ulcers. The foot ulcer prevalence in diabetes inpatients was 15.1% and in non-diabetes inpatients was 4.1% (p<0.001). Independent factors associated with foot ulcers in diabetes inpatients were moderate PAD, previous foot ulcer history and peripheral neuropathy (p<0.01). Independent factors associated with foot ulcers in non-diabetes inpatients were moderate PAD, previous foot ulcer history and a cancer history (p<0.05).
These findings indicate the prevalence of diabetes-related and non-diabetes-related foot ulcers is similar in representative inpatients; however, diabetes inpatients have much higher rates of foot ulcers than non-diabetes inpatients. Foot ulcers in inpatients are more likely in those with moderate PAD and a previous foot ulcer history, regardless of self-reported diabetes status. These findings may assist with identifying inpatients with foot ulcers; however more research is required into risk factors for foot ulcers in representative inpatient populations.