Demographics and outcomes of inpatients with diabetic foot ulcers treated conservatively and surgically in a metropolitan hospital network
| Autor: | Leon A. Bach, Annabel S Jones, Luisa M. Rosi, Duncan J. Topliss |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Demographics Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Amputation Surgical 03 medical and health sciences 0302 clinical medicine Endocrinology Risk Factors Diabetes mellitus Internal Medicine medicine Humans 030212 general & internal medicine Aged Demography Retrospective Studies Hospital network Inpatients business.industry Medical record Retrospective cohort study General Medicine Middle Aged medicine.disease Diabetic foot Survival Analysis Diabetic Foot Hospitalization medicine.anatomical_structure Treatment Outcome Amputation Emergency medicine Female Ankle business |
| Zdroj: | Diabetes research and clinical practice. 175 |
| ISSN: | 1872-8227 |
| Popis: | To describe the demographics of patients with diabetic foot ulcers (DFU) and their impact on inpatient management. Secondary outcomes identified relationships of treatment modality with mortality, length of hospital admission, readmissions and post-admission care.Retrospective cohort study including patients with DFU admitted to a hospital network in Melbourne, Australia from 2016 to 2018. Medical records were manually reviewed for acute admission with DFU as a major presenting diagnosis; incidental ulcers and traumatic amputations were excluded. Amputations distal and proximal to the ankle were labelled 'minor' and 'major' respectively. Patients were followed until October 31, 2019.Of 338 patients, 21 and 148 had major and minor amputations, and 169 were managed conservatively. 94% had ≥1 microvascular and/or macrovascular complication. Conservative management (7 days) was associated with a shorter length of stay (major 18, minor 10 days, p 0.001). Readmission rates were not significantly different. Mortality was greatest (38%) and survival time shortest (999 days) after major amputation than after either other treatment. Other factors associated with mortality were age and a history of coronary artery disease.Early identification and multi-disciplinary management of DFU is essential to reduce the significant morbidity and mortality associated with amputation in these complex patients. |
| Databáze: | OpenAIRE |
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