Presentation (CTI)

OBJECTIVES: Diabetic foot ulcers (DFUs) are among the most debilitating complications of diabetes mellitus and a primary cause of hospitalizations and lower extremity amputations. In Germany, demographic changes and rising diabetes prevalence underscore the importance of updated epidemiological data. This study investigates national trends in DFU-associated hospitalizations and the incidence of minor and major foot amputations from 2019 to 2024.
METHODS: National health insurance data, hospital discharge statistics (based on ICD-10-GM and OPS codes), and epidemiological data from the Robert Koch Institute (RKI) were analyzed. Minor amputations were defined as procedures distal to the ankle joint, while major amputations were proximal to the ankle.
RESULTS: Between 2019 (56,908 cases) and 2024 (56,847 cases) hospitalizations for diabetic foot complications in Germany remained unchanged, but with a dip down to 50,480 cases in 2022. 94.8% of patients were coded as type-2-diabetes, 76.8% were male. The number of hospital days dropped from 886,451 to 795,415 (-10.3%) shortening the average length of stay from 15.6d (2019) to 14.0d (2024). During the same period, the number of foot amputations increased from 23,046 (2019) to 23,378 (+1.4%) in 2024. The share of major amputations was 11.8% (2,720) in 2019 and 12.5% (2,917) in 2024. Thus, major amputations increased by 7.2% and minor amputations by 0.7% in this period. The share of amputations in type-2-diabetes patients was 96.1% (22,136) in 2019 and 96.0% (22,437) in 2024. The share of male patients with amputation was 80.7% in 2024. Average length of stay was 18.0d with minor and 29.5d with major amputations in 2024.
CONCLUSIONS: Since 2019, Germany has seen a stable number in DFU-related hospitalizations but an increase in DFU-related major and minor foot amputations. This rise underscores the need for further research into early preventive measures, continued monitoring, and targeted interventions to frame this trend.