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Diabetic foot ulcers

Diabetic foot ulcers and infections significantly up burden of care

Diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) are associated with increased risks of admission and outpatient visits, according to a study published Diabetes Care. They found that an estimated 6.7 million diabetic foot cases indicates markedly greater risks for both ED/IP admissions and number of outpatient visits, with DFUs also associated with a higher odds of referrals to other physicians and longer physician visit times.

(Credit: Intermedichbo at Serbian Wikipedia)

Diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) are associated with increased risks of admission and outpatient visits, according to a study published Diabetes Care. They found that an estimated 6.7 million diabetic foot cases indicates markedly greater risks for both ED/IP admissions and number of outpatient visits, with DFUs also associated with a higher odds of referrals to other physicians and longer physician visit times.

Dr Grant H Skrepnek from the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues conducted a cross-sectional historical cohort analysis using the nationally representative US Centers for Disease Control and Prevention National Ambulatory Medical Care Survey data from 2007 to 2013. Data were included for patients age ≥18 years with diabetes and either DFIs and DFUs.

The study, ‘Health Care Service and Outcomes Among an Estimated 6.7 Million Ambulatory Care Diabetic Foot Cases in the US’, evaluated ambulatory clinical cases of DFUs and DFIs in the US from 2007 to 2013 and to assess outcomes of emergency department or inpatient (ED/IP) admission, number of clinic visits per year, and physician time spent per visit.

The researchers used a cross-sectional historical cohort analysis was conducted by using the nationally representative Centers for Disease Control and Prevention National Ambulatory Medical Care Survey data from 2007 to 2013, including patients age ≥18 years with diabetes and either DFIs or DFUs. Study outcomes were analysed by using generalized linear models controlling for key demographics and chronic conditions.

The researchers found that about 6.7 million (0.8 percent) of the estimated 5.6 billion ambulatory care visits were for DFUs and DFIs (0.3 and 0.5 percent, respectively). Relative to other ambulatory clinical cases, DFUs correlated with 3.4-fold increased odds of direct emergency department referral or inpatient admission (CI 1.01–11.28; p=0.049), 2.1-fold increased odds of referral to another physician (CI 1.14–3.71; p=0.017), 1.9-fold more visits in the past 12 months (CI 1.41–2.42; p<0.001), and 1.4-fold longer time spend per visit with the physician (CI 1.03–1.87; p=0.033), in multivariate analyses. For DFIs there were independent associations with 6.7-fold increased odds of direct emergency department referral or inpatient admission (CI 2.25–19.51; p<0.001), and 1.5-fold more visits in the past 12 months (CI 1.14–1.90; p=0.003).

"This investigation of an estimated 6.7 million diabetic foot cases indicates markedly greater risks for both ED/IP admissions and number of outpatient visits," the authors write.