A systematic review with meta-analysis of the impact of access and quality of diabetic foot care delivery in preventing lower extremity amputation
| Autor: | João Martiniano, Sofia Pinheiro-Torres, Edward J. Boyko, Vanessa Dias, Jorge Vale-Lima, Matilde Monteiro-Soares |
|---|---|
| Přispěvatelé: | Veritati - Repositório Institucional da Universidade Católica Portuguesa |
| Rok vydání: | 2020 |
| Předmět: |
Risk
medicine.medical_specialty Endocrinology Diabetes and Metabolism Lower extremity amputation 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Amputation Surgical Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Endocrinology Diabetes mellitus Health care Internal Medicine Medicine Humans Foot ulcer business.industry Diabetic foot care Podiatry Lower Extremity Amputation Odds ratio medicine.disease Diabetic foot Diabetic Foot Meta-analysis Lower Extremity Systematic review Physical therapy business |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| ISSN: | 1873-460X |
| Popis: | Aims To assess the impact of diabetic foot care delivery in preventing lower extremity amputation (LEA). Methods We systematically searched the MEDLINE database for research evaluating the association between any aspect of diabetic foot care delivery and risk of LEA. Meta-analysis was conducted by calculating a pooled odds ratio through a random effects model. Results Our search retrieved 5093 articles. In total, 58 articles were included: 9 addressing healthcare access, 4 educating health professionals, 2 implementing guidelines, 6 receiving chiropody/podiatry care services and 37 implementing structured diabetic foot care services (SDFC). All of these aspects of diabetic foot care seemed to have a positive impact on preventing LEA. Only SDFC literature met criteria for performing a meta-analysis. For SDFC impact on preventing overall and major LEA but not for minor LEA compelling evidence was observed [aggregated odds ratio (OR) of 0.45 (95% CI 0.37–0.57), 0.40 (95% CI 0.32–0.51), and 0.87 (95% CI 0.67–1.14), respectively]. However, high heterogeneity (superior to 60%) was observed for all outcomes. Conclusions Results support a reduction in diabetic LEA frequency in association with structured diabetic foot care, and, in particular, major LEA. Less evidence is available for the remaining aspects of diabetic foot care delivery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect