Comparison of Severity in Diabetic Ulcer Patients with and Without Sepsis

Authors

  • Siti Roisya Aga Maydiana Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
  • Evi Nurhayatun Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
  • Desy Puspa Putri Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia

DOI:

https://doi.org/10.31965/infokes.Vol22.Iss2.1221

Keywords:

Diabetes Mellitus, Diabetic Ulcer Severity, Sepsis, Wagner's Criteria

Abstract

Diabetes mellitus patients in Central Java grow yearly. According to data provided by the Central Java Health Department in 2019, Diabetes mellitus ranks second as the largest non-communicable disease (NCD), covering 13,4% of the total NCD patients. The prevalence of diabetic ulcers is 15-25% of all diabetes mellitus patients in Indonesia, which concerns the author regarding the possible increase of the diabetic ulcer population in Central Java. The severity of diabetic ulcers depends on various factors, including infection and complications. The most common complication is sepsis, a systemic infection often arising from local infections that are not appropriately treated, causing progressive damage and increasing mortality rates. This study aims to examine the comparison of ulcer severity in diabetic ulcer patients with sepsis and non-sepsis complications using Meggitt Wagner's criteria. This study utilizes an analytic observational study using a cross-sectional approach. The author sampled 126 patients diagnosed with Diabetic Ulcers in 2022 at Dr. Moewardi General Hospital for this study, using a purposive sampling method. The research was conducted by looking at the patient's medical record data, and data analysis using SPSS software. The test used in this research includes a Parametric T-independent test and a Pearson bivariate relationship test. This study shows that the comparison of ulcer severity in diabetic ulcer patients with sepsis and without sepsis was statistically significant (p-value = 0.000002). The mean of the group with sepsis (3.4127) was greater than the group without sepsis (2.5238). In conclusion, the comparison of ulcer severity in diabetic ulcer patients with sepsis and without sepsis is significant. We recommend future researchers include patients’ comorbidities, total hospitalization time, and detailed information on drug use and patient adherence to treatment in their research for more nuanced findings.                 

Downloads

Download data is not yet available.

References

Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018). Sepsis and septic shock. The Lancet, 392(10141), 75–87. https://doi.org/10.1016/S0140-6736(18)30696-2

Chen, L., Sun, S., Gao, Y., & Ran, X. (2023). Global mortality of diabetic foot ulcer: A systematic review and meta-analysis of observational studies. Diabetes, Obesity and Metabolism, 25(1), 36–45. https://doi.org/10.1111/dom.14840

Conover, W. J., Guerrero-Serrano, A. J., & Tercero-Gómez, V. G. (2018). An update on ‘a comparative study of tests for homogeneity of variance’. Journal of Statistical Computation and Simulation, 88(8), 1454-1469. https://doi.org/10.1080/00949655.2018.1438437

Dinas Kesehatan Provinsi Jawa Tengah. (2019). Profil Kesehatan Provinsi Jateng Tahun 2019. Dinas Kesehatan Provinsi Jawa Tengah.

Dörr, S., Schlecht, M., Chatzitomaris, A., Weisser, G., Lucke-Paulig, L., Friedl, A., ... & Lobmann, R. (2021). Predictive effect of inflammatory response and foot ulcer localization on outcome in younger and older individuals with infected diabetic foot syndrome. Experimental and Clinical Endocrinology & Diabetes, 129(12), 878-886.

Everett, E., & Mathioudakis, N. (2018). Update on management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153–165. https://doi.org/10.1111/nyas.13569

Goh, T. C., Bajuri, M. Y., Nadarajah, S. C., Rashid, A. H. A., Baharuddin, S., & Zamri, K. S. (2020). Clinical and bacteriological profile of diabetic foot infections in a tertiary care. Journal of foot and ankle research, 13(1), 1–8.

Goyal, R., Jialal, I., & Delhi, N. (2023). Type 2 Diabetes. StatPearls Publishing.

Gunawan, B., Pangalila, F., & Ludong, M. (2019). Hubungan tingkat keparahan sepsis dengan Diabetes Melitus tterkontrol dan tidak terkontrol menggunakan parameter HbA1C di Rumah Sakit Royal Taruma Jakarta Barat periode 2015-2017. Tarumanagara Medical Journal, 1(2), 277–290.

Huang, M., Cai, S., & Su, J. (2019). The pathogenesis of sepsis and potential therapeutic targets. International Journal of Molecular Sciences, 20(21). https://doi.org/10.3390/ijms20215376

Jeffcoate, W. J., Vileikyte, L., Boyko, E. J., Armstrong, D. G., & Boulton, A. J. M. (2018). Current Challenges and Opportunities in the Prevention and Management of Diabetic Foot Ulcers. 41(April), 645–652. https://doi.org/10.2337/dc17-1836

Kementerian Kesehatan, R.I. (2020). Peraturan Menteri Kesehatan Republik Indonesia Nomor 2 Tahun 2020 Tentang Standar Antropometri Anak. Jakarta: Kementerian Kesehatan Republik Indonesia.

Kim T. K. (2015). T test as a parametric statistic. Korean journal of anesthesiology, 68(6), 540–546. https://doi.org/10.4097/kjae.2015.68.6.540

Lin, C. W., Hung, S. Y., Huang, C. H., Yeh, J. T., & Huang, Y. Y. (2019). Diabetic foot infection presenting systemic inflammatory response syndrome: a unique disorder of systemic reaction from infection of the most distal body. Journal of Clinical Medicine, 8(10), 1538.

Liu, X., Ren, Q., Zhai, Y., Kong, Y., Chen, D., & Chang, B. (2022). Risk factors for multidrug-resistant organisms infection in diabetic foot ulcer. Infection and Drug Resistance, 1627-1635.

Matta-Gutierrez, G., Garcia-Morales, E., Garcia-Alvarez, Y., Álvaro-Afonso, F. J., Molines-Barroso, R. J., & Lazaro-Martinez, J. L. (2021). The influence of multidrug-resistant bacteria on clinical outcomes of diabetic foot ulcers: a systematic review. Journal of Clinical Medicine, 10(9), 1948.

Monteiro-Soares, M., Russell, D., Boyko, E. J., Jeffcoate, W., Mills, J. L., Morbach, S., & Game, F. (2019). IWGDF Guideline on the classification of diabetic foot ulcers. International Working Group on the Diabetic Foot, 1–15.

Najihah. (2020). Infeksi Luka Kaki Diabetik dan Faktor Resikonya : Literature Review. Jurnal Ilmiah Kesehatan Pencerah, 09(2), 179–185.

Orcan, F. (2020). Parametric or Non-parametric : Skewness to Test Normality for Mean Comparison. 7(2), 255–265.

Park, J. H., Suh, D. H., Kim, H. J., Lee, Y. I., Kwak, I. H., & Choi, G. W. (2017). Role of procalcitonin in infected diabetic foot ulcer. Diabetes research and clinical practice, 128, 51-57.

Perez-Favila, A., Martinez-Fierro, M. L., Rodriguez-Lazalde, J. G., Cid-Baez, M. A., Zamudio-Osuna, M. D. J., Martinez-Blanco, M. D. R., … Garza-Veloz, I. (2019). Current therapeutic strategies in diabetic foot ulcers. Medicina (Lithuania), 55(11), 1–21. https://doi.org/10.3390/medicina55110714

Primadina, N., Basori, A., & Perdanakusuma, D. S. (2019). Proses penyembuhan luka ditinjau dari aspek mekanisme seluler dan molekuler. Qanun Medika-Medical Journal Faculty of Medicine Muhammadiyah Surabaya, 3(1), 31-43.

Schofield, H., Haycocks, S., Robinson, A., Edmonds, M., Anderson, S. G., & Heald, A. H. (2021). Mortality in 98 type 1 diabetes mellitus and type 2 diabetes mellitus: Foot ulcer location is an independent risk determinant. Diabetic Medicine, 38(10), e14568. https://doi.org/10.1111/dme.14568

Stang, D., & Young, M. (2018). ulcer classification system in Scotland : part 2. The Diabetic Foot Journal, 21(2), 100–106.

Sukartini, T., Theresia Dee, T. M., Probowati, R., & Arifin, H. (2020). Behaviour model for diabetic ulcer prevention. Journal of Diabetes and Metabolic Disorders, 19(1), 135–143. https://doi.org/10.1007/s40200-019-00484-1

Syafril, S. (2018). Pathophysiology diabetic foot ulcer. IOP Conference Series: Earth and Environmental Science, 125(1). https://doi.org/10.1088/1755-1315/125/1/012161

Syauta, D., Hendarto, J., Mariana, N., Kusumanegara, J., & Faruk, M. (2021). Risk factors affecting the degree of diabetic foot ulcers according to Wagner classification in diabetic foot patients ଝ. Medicina Clínica Práctica, 4, 100231. https://doi.org/10.1016/j.mcpsp.2021.100231

Utami, M. P. S., Marselin, A., & Hartanto, F. A. D. (2021). Indonesian Journal of Global Health Research. 3(3), 407–414.

Wang, Y., Shao, T., Wang, J., Huang, X., Deng, X., Cao, Y., … Zhao, C. (2021). An update on potential biomarkers for diagnosing diabetic foot ulcer at early stage. Biomedicine and Pharmacotherapy, 133(July 2020), 110991. https://doi.org/10.1016/j.biopha.2020.110991

Yan, X., Song, J., Zhang, L., & Li, X. (2022). Analysis of risk factors for multidrug ‑ resistant organisms in diabetic foot infection. BMC Endocrine Disorders, 1–7. https://doi.org/10.1186/s12902-022-00957-0

Downloads

Published

2024-06-30

How to Cite

Maydiana, S. R. A., Nurhayatun, E., & Putri, D. P. (2024). Comparison of Severity in Diabetic Ulcer Patients with and Without Sepsis. JURNAL INFO KESEHATAN, 22(2), 214–220. https://doi.org/10.31965/infokes.Vol22.Iss2.1221

Issue

Section

Original Articles

Similar Articles

1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.