Hospitalized diabetic foot ulcer patients at an Ethiopian tertiary hospital presented with advanced disease and experienced a very high lower-extremity amputation burden (53.4%), with longer diabetes duration, longer ulcer duration, previous foot ulcer, and University of Texas stage C/D associated with higher odds of amputation.
Over half of hospitalized diabetic foot ulcer patients underwent lower-extremity amputation.
Most patients presented with advanced ulcer disease.
The study population was middle-aged to older adults.
Diabetes duration of 10 years or more was associated with higher odds of amputation.
Longer ulcer duration before presentation was associated with higher odds of amputation.
A previous foot ulcer was associated with higher odds of amputation.
Advanced University of Texas stage (C or D) was associated with higher odds of amputation.
The authors conclude the high in-hospital amputation rate reflects disparities in preventive and limb-saving diabetic foot care in low-income settings.
This study reviewed the records of 146 people with diabetes who were hospitalized for foot ulcers at a large public hospital in Ethiopia over five years. Most arrived with severe wounds: more than 86% had advanced ulcers by one grading system, and about 60% were at advanced stages by another. More than half (53.4%) ended up having part of a leg or foot amputated. People were more likely to have an amputation if they had lived with diabetes for 10 years or more, had a previous foot ulcer, had an ulcer at an advanced stage, or had waited longer before coming to the hospital. Each extra day of delay was linked to slightly higher odds of amputation. This research suggests that late presentation and advanced disease are major contributors to limb loss in this setting, and that prevention and early limb-saving care may be lacking in low-income countries. As a retrospective single-hospital review, it shows associations rather than proving cause, and may not represent all patients in Ethiopia.
Amogne M, Gorfe F, David K, Reja A. (2026). Clinical Outcomes of Patients Hospitalized With Diabetic Foot Ulcer at a Tertiary Hospital in Ethiopia: A 5-Year Retrospective Audit.. International wound journal. https://doi.org/10.1111/iwj.71086