Outcomes of Patients Admitted for Infected Diabetic Foot Attack: Difference Between Patients with and Without Peripheral Artery Disease

Objectives: To assess the impact of peripheral artery disease (PAD) on the outcomes of patients admitted for infected diabetic foot attack (DFA). Methods: Retrospective observational study of consecutive patients admitted to a third-level multidisciplinary diabetic foot service in 2024 for diabetic foot ulcers (DFUs) complicated by moderate or severe infection. Based on the presence of PAD, patients were divided into two groups: those with neuro-ischemic DFA (PAD+), treated with prompt revascularization, and those with neuropathic DFA (PAD-). The following in-hospital outcomes were evaluated: minor and major amputations; length of stay (LOS); mortality. Once discharged, patients were regularly followed as outpatients, and their six-month outcomes (healing, major amputation, and mortality) were analyzed. Results: Overall, 119 patients were included (70% PAD+ vs. 30% PAD-). The mean age was 67 ± 13 years, most patients were male (75%) and had type 2 diabetes (92%) with a mean duration of 20 ± 12 years. In-hospital outcomes for the two groups (PAD+ vs. PAD-) were as follows: minor amputation (41.7 vs. 25.7%, p = 0.09); major amputation (2.4 vs. 2.9%, p = 0.8); LOS (21 ± 11 vs. 14 ± 11 days, p = 0.004); mortality (3.6 vs. 0%, p = 0.1). The six-month follow-up outcomes (PAD+ vs. PAD-) were as follows: healing (40.5 vs. 90.6%, p < 0.0001); major amputation (8.1 vs. 3.1%, p = 0.1); mortality (8.1 vs. 0%, p = 0.01). Additionally, PAD (OR 3.6, CI: 1.4–12.1, p = 0.001) was independently related to non-healing. Conclusions: In the context of infected DFA, PAD appeared to play a significant role only in hospitalization length, while having greater influence on mid-term outcomes at the six-month follow-up, particularly in reducing healing chances.