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Vol. 225. Issue 3.
Pages 117-178 (March 2025)
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Vol. 225. Issue 3.
Pages 117-178 (March 2025)
Original article

Diabetic foot infections in Internal Medicine services in Spain (2018–2022)

Infecciones de pie de diabético en los servicios de Medicina Interna de España (2018–2022)
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C. Fuentes Santosa,b,c,
Corresponding author
, J.A. Rueda Caminoa,c,d, Á. Asenjo Motaa,c, A. Castaneda Pastora,c, A. Zapatero Gaviriab,c,e, J. Canora Lebratoc,f, R. Barba-Martína,b,c,d
a Servicio Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
b Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Madrid, Spain
c Grupo Gestión, Sociedad Española Medicina Interna, Spain
d Hospital Universitario Rey Juan Carlos, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
e Servicio Medicina Interna, Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain
f Servicio Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Abstract
Introduction

Diabetic foot infections represent a common and serious complication of diabetes mellitus, with a wide range of clinical presentations. Despite their significance, uncertainties persist regarding their management and impact on Internal Medicine services.

Materials and methods

A retrospective cohort study was conducted using data from the Registry of Specialized Healthcare Activity (RAE-CMBD) over a five-year period (2018−22). Patients discharged from Internal Medicine with a diagnosis of diabetic foot were included. Demographic, clinical, and activity data were collected, and the cumulative incidence of diabetic foot, in-hospital mortality, need for amputation, and associated costs of hospitalization were analyzed.

Results

15,402 episodes with a diagnosis of diabetic foot were identified, representing 0.41% of Internal Medicine, which implies an age-adjusted incidence rate of between 2 and 3 cases per 1000 admissions in these services. These patients had a high in-hospital mortality rate (16%) and a significant percentage required amputation (8.25%). Advanced age, the presence of comorbidities, and complications during admission were associated with a higher risk of mortality and amputation. The average cost per admission is over ;6000.

Conclusions

Diabetic foot is a pathology with a high impact on Internal Medicine services, both due to the volume of activity and the high mortality and cost generated by this condition.

Keywords:
Diabetic foot infections
Diabetes
Mortality
Cost
Administrative data base
Resumen
Introducción

Las infecciones del pie diabético representan una complicación común y grave de la diabetes mellitus, con una amplia gama de presentaciones clínicas. A pesar de su importancia, aún existe incertidumbre sobre su impacto en los servicios de Medicina Interna.

Material y métodos

Se realizó un estudio de cohortes retrospectivo utilizando datos del Registro de Actividad Sanitaria Especializada (RAE-CMBD) durante un período de cinco años (2018−22). Se incluyeron pacientes dados de alta en Medicina Interna con un diagnóstico de pie diabético. Se recopilaron datos demográficos, clínicos y de actividad, y se analizó la incidencia acumulada de pie diabético, la mortalidad intrahospitalaria, la necesidad de amputación y el coste que supone el ingreso de estos pacientes.

Resultados

Se identificaron 15402 episodios con un diagnóstico de pie diabético, lo que representó el 0,41% de las altas de Medicina Interna durante el período; esto supone una tasa de incidencia ajustada por edad de entre 2 y 3 casos por cada 1000 ingresos en dichos servicios. Estos pacientes tenían una alta mortalidad intrahospitalaria (16%) y un porcentaje significativo requirió amputación (8,25%). La edad avanzada, la presencia de comorbilidades y las complicaciones durante el ingreso se asociaron con un mayor riesgo de mortalidad y amputación. El coste medio por ingreso supone más de 6000;.

Conclusiones

El pie diabético es una patología con alto impacto en los servicios de Medicina Interna, tanto por el volumen de actividad, como por la elevada mortalidad y coste generado por dicha entidad.

Palabras clave:
Ulcera pie diabético
Diabetes
Mortalidad
Coste
Base datos administrativa

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