Incidence of diabetic foot ulcer and its predictors among adult diabetes patients in Northern Ethiopia: a retrospective cohort study

Abstract

Diabetic foot ulcer (DFU) is a leading cause of lower limb amputation worldwide. The rate of diabetes-related amputations is rising in Ethiopia. However, the incidence of diabetic foot ulcer and its predictors were less studied in Ethiopia, particularly in the study area. An institution-based retrospective cohort study was conducted. Systematic random sampling was used to select a sample of 321 patients out of 1050 diabetes patients. Data were entered into EpiData and analysed using SPSS. Kaplan-Meier survivor functions were used for survival analysis. Cox proportional hazard regression was used to identify predictors, and multivariable analysis was declared with a p ≤ 0.25. The incidence of diabetic foot ulcers was 1.01 per 100 person-years (95%: CI, 0.74–1.40. Obesity (AHR = 2.94: 95% CI: 1.11–7.79), neuropathy (AHR = 2.94: 95% CI: 1.47–5.90), rural residence (AHR = 2.73: 95% CI: 1.27–5.88), hypertension (AHR = 5.61: 95% CI: 2.49–12.90), age ≥ 70 years (AHR = 15.03: 95% CI: 3.58–63.10) and abnormal high-density lipoprotein (AHR = 3.71: 95% CI: 1.81–7.62) increased the hazard of diabetic foot ulcer. The overall incidence of diabetic foot ulcers was relatively low in this cohort. We recommend targeted intervention, including regular screening, patient education, and early therapeutic management.