Clinical Outcomes of Patients Hospitalized With Diabetic Foot Ulcer at a Tertiary Hospital in Ethiopia: A 5‐Year Retrospective Audit

Diabetic foot ulcer is a major cause of hospitalization and lower extremity amputation, particularly in low-resource settings where patients frequently present with advanced wound. This study assessed the clinical outcomes of patients admitted with diabetic foot ulcer. We conducted a retrospective study of patients admitted to a public hospital in Ethiopia with diabetic foot ulcer. The primary outcome was lower-extremity amputation. Descriptive analyses, bivariate comparisons, and logistic regression were performed. A total of 146 patients hospitalized with diabetic foot ulcer were included. The mean (±SD) age was 59.4 (±11.7) years. Most patients presented with advanced disease: 86.3% had Wagner grade ≥ 3% and 60.3% had Texas stage C/D. Overall, 53.4% underwent lower-extremity amputation. Factors associated with higher odds of amputation were: long standing diabetes (duration ≥ 10 years: Adjusted Odds Ratio: 2.42; [95% Confidence Interval: 1.01-5.80]), longer ulcer duration (every day of delayed presentation: 1.02 [1.01-1.03]), previous foot ulcer (4.34 [1.55-12.13]), advanced ulcer stages with University of Texas stage C or D (2.86 [1.19-6.90]). Hospitalized diabetic foot ulcer patients presented with advanced disease and experienced a very high lower-extremity amputation burden. This high in-hospital amputation rate in a low-income country highlights the profound disparity in preventive and limb-saving diabetic foot interventions.