{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:52:42Z","timestamp":1791575562804,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020317","name":"Essity Germany","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020317","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Due to limited data on the epidemiology of diabetic foot ulcers (DFU) in Germany, especially for those infected, the study determined the prevalence and incidence of DFU and the associated medical burden. Anonymised claims data of 3.3 million insured lives were sourced from a statutory health insurance fund. Patients with DFU between 04\/01\/2016 and 12\/31\/2019 were selected (<jats:italic>n<\/jats:italic>\u2009=\u20097764) and divided into patients with\/without infection\/with prophylactic use of antibiotics. Outcome variables were described categorically. Two\u2010sided <jats:italic>t<\/jats:italic>\u2010tests and chi\u2010squared tests (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) were performed. The prevalence and incidence in patients with DFU was 4.6% and 2.1%, respectively. The mean Charlson Comorbidity Index was 7.9, significantly higher in those infected than in those uninfected (8.1% vs. 7.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Amputations occurred significantly more often in DFU patients with infection than in those without (minor 25.4% vs. 3.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; major 6.7% vs. 1.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The 5\u2010year mortality rate was significantly higher in patients with infection than in those without (64.0% vs. 51.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The occurrence of comorbidities and complications associated with DFU, in particular the high overall medical burden and mortality rate\u2014especially in DFU patients with infections\u2014underscores the importance of prevention and early, appropriate treatment.<\/jats:p>","DOI":"10.1111\/iwj.70157","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T23:09:01Z","timestamp":1743030541000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Epidemiology and the Medical Burden of Diabetic Foot Ulcers Especially in Patients With Infection\u2014A Population\u2010Based Analysis From Germany"],"prefix":"10.1111","volume":"22","author":[{"given":"J\u00fcrgen","family":"Wernecke","sequence":"first","affiliation":[{"name":"Clinic for Diabetes Agaplesion Diakonieklinikum Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Wernecke","sequence":"additional","affiliation":[{"name":"Clinic for Diabetes Agaplesion Diakonieklinikum Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Ebenau","sequence":"additional","affiliation":[{"name":"BSN medical GmbH (Essity Group)  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Spruth","sequence":"additional","affiliation":[{"name":"BSN medical GmbH (Essity Group)  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareike","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"LinkCare GmbH  Ludwigsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Vogelmann","sequence":"additional","affiliation":[{"name":"LinkCare GmbH  Ludwigsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"York","family":"Z\u00f6llner","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Hamburg University of Applied Sciences  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-020-03211-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1284-6412"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3654"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-2082-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3651"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3280"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177916"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2010.10.003"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3165"},{"key":"e_1_2_10_14_1","article-title":"IWGDF\/IDSA Guidelines on the Diagnosis and Treatment of Diabetes\u2010Related Foot Infections (IWGDF\/IDSA 2023)","volume":"66","author":"Senneville \u00c9.","year":"2024","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_15_1","first-page":"130","article-title":"Lower Limb Amputation in Germany","volume":"114","author":"Kr\u00f6ger K.","year":"2017","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"e_1_2_10_16_1","unstructured":"Deutsche Gesellschaft f\u00fcr Wundheilung und Wundbehandlung e. 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