Neighborhood socioeconomic disadvantage is not associated with wound healing in diabetic foot ulcer patients treated in a multidisciplinary setting
| Autor: | Christopher J. Abularrage, Joseph K. Canner, Nestoras Mathioudakis, Caitlin W. Hicks, James H. Black, Christopher K Lippincott, Ronald L. Sherman, Kathryn F. Hines |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population 030204 cardiovascular system & hematology 03 medical and health sciences Young Adult 0302 clinical medicine Residence Characteristics Diabetes mellitus Internal medicine medicine Poor wound healing Humans 030212 general & internal medicine education Child Aged Proportional Hazards Models Retrospective Studies education.field_of_study Wound Healing Insurance Health integumentary system Proportional hazards model business.industry Hazard ratio Infant Newborn Infant Middle Aged medicine.disease Confidence interval Diabetic Foot Diabetic foot ulcer Social Class Child Preschool Cohort Income Surgery Female business |
| Zdroj: | The Journal of surgical research. 224 |
| ISSN: | 1095-8673 |
| Popis: | Background Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. Methods Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most). Predictors of wound healing were assessed using Cox proportional hazards models accounting for patient demographics, wound characteristics, and ADI category. Results Six hundred twenty-one wounds were evaluated, including 59% ADI-0, 7% ADI-1, 12% ADI-2, and 22% ADI-3. After accounting for patient demographics and wound characteristics, the likelihood of wound healing was similar between groups (ADI-3 versus ADI-0: hazards ratio [HR] 1.03 [95% confidence interval 0.76-1.41]). Independent predictors of poor wound healing included peripheral arterial disease (HR 0.75), worse wound stage (stage 4: HR 0.48), larger wound area (HR 0.99), and partially dependent functional status (HR 0.45) (all, P Conclusions In a multidisciplinary setting, wound healing was largely dependent on wound characteristics and vascular status rather than patient demographics or neighborhood socioeconomic disadvantage. Use of a multidisciplinary approach to the management of DFU may overcome the negative effects of socioeconomic disadvantage frequently described in the diabetic population. |
| Databáze: | OpenAIRE |
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