Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work.
Rev Esp Quimioter
; 27(3): 170-9, 2014 Sep.
Article
em En
| MEDLINE
| ID: mdl-25229372
ABSTRACT
OBJECTIVE:
To assess changes in diabetic lower-extremity amputations (LEA) rates in a defined population over a 15-year period, following a multidisciplinary approach including a critical pathway in an inpatient setting with standardized preoperative and postoperative care, as well as in an outpatient setting through the establishment of a diabetic foot clinic.METHODS:
This is a study of the incidence and types of LEAs performed in patients with diabetic foot disease complicated admitted to Morales Meseguer Hospital (Murcia, Spain), a large district general hospital, before (1998-2000) and after (2001-2012) of the introduction of better organized diabetes foot care. Hospital and clinic characteristics to the success of the programme are described. All cases of LEA in diabetic patients (1998-2012) within the area were identified by ICD-9-Clinical modification (CM) diagnostic codes. A chi square test was used to compare the frequency and level of amputations.RESULTS:
Over all inpatients with diabetes admitted with foot infections and gangrene, there was a significant decrease in the proportion of total major amputations (47%) and elective major amputations (66%) (p<0.001). The incidence of total major amputations rates per 100.000 of the general population fell with statistical significance (p=0.009). The biggest improvement in LEA incidence was seen in the reduction of major elective amputation with fell 60%, from 7.6 to 3.1 per 100,000 (p<0.001).CONCLUSIONS:
Significant reductions in total and major amputations rates occurred over the 15-year period following improvements in foot care services included multidisciplinary teamwork (critical pathway and diabetic foot clinic).
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Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
/
Complicações do Diabetes
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Amputação Cirúrgica
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Rev Esp Quimioter
Ano de publicação:
2014
Tipo de documento:
Article