Multidisciplinary Limb Salvage Service Reduces Major Amputations in Diabetic Foot Infections.
J Am Podiatr Med Assoc
; 113(2)2023.
Article
en En
| MEDLINE
| ID: mdl-37134060
ABSTRACT
BACKGROUND:
Diabetic foot infections (DFIs) can lead to limb loss and mortality. To improve patient care at a safety-net teaching hospital, we created a multidisciplinary limb salvage service (LSS).METHODS:
We recruited a cohort prospectively and compared it to a historical control group. Adults admitted to the newly established LSS for DFI during a 6-month period from 2016 to 2017 were included prospectively. Patients admitted to the LSS had routine endocrine and infectious diseases consultations according to a standardized protocol. A retrospective analysis of patients admitted to the acute care surgical service for DFI before creation of the LSS during an 8-month period from 2014 to 2015 was performed.RESULTS:
A total of 250 patients were divided into two groups the pre-LSS (n = 92) and the LSS (n = 158) groups. There were no significant differences in baseline characteristics. Although all patients were ultimately diagnosed with diabetes, more patients in the LSS group had hypertension (71% versus 56%; P = .01) and a prior diagnosis of diabetes mellitus (92% versus 63%; P < .001) compared to the pre-LSS group. Significantly, with the LSS, fewer patients underwent a below-the-knee amputation (3.6% versus 13%; P = .001). There was no difference in the length of hospital stay or 30-day readmission rate between the groups. Further broken down into Hispanic versus non-Hispanic, we noted that Hispanics had significantly lower rates of below-the-knee amputations (3.6% versus 13.0%; P = .02) in the LSS cohort.CONCLUSIONS:
The initiation of a multidisciplinary LSS decreased the below-the-knee amputation rate in patients with DFIs. Length of stay was not increased, nor was the 30-day readmission rate affected. These results suggest that a robust multidisciplinary LSS dedicated to the management of DFIs is both feasible and effective, even in safety-net hospitals.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
2_enfermedades_transmissibles
/
6_cardiovascular_diseases
/
6_diabetes
/
6_endocrine_disorders
/
6_skin_diseases
Asunto principal:
Enfermedades Transmisibles
/
Pie Diabético
/
Diabetes Mellitus
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Observational_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
J Am Podiatr Med Assoc
Asunto de la revista:
PODIATRIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Canadá