Outpatient clinic attendance and outcomes among patients hospitalized with diabetic foot ulcers
Copyright © 2022 Elsevier Inc. All rights reserved..
BACKGROUND: There are limited data on post-hospital discharge clinic attendance rates and outcomes among patients with diabetic foot ulcers (DFUs).
METHODS: Retrospective study of patients hospitalized with a DFU from 2016 to 2019 in a large public hospital. We measured rates and predictors of clinic attendance with providers involved with DFU care within 30 days of hospital discharge ("30-day post-discharge clinic attendance"). Log-binomial regression was used to estimate risk ratios (RR) and 95 % confidence intervals (CI).
RESULTS: Among 888 patients, 60.0 % were between 45 and 64 years old, 80.5 % were Black, and 24.1 % were uninsured. Overall, 478 (53.8 %) attended ≥1 30-day post-discharge clinic appointment. Initial hospital outcomes were associated with clinic attendance. For example, the RR of 30-day post-discharge clinic attendance was 1.39 (95%CI 1.19-1.61) among patients who underwent a major amputation compared to patients with DFUs without osteomyelitis and did not undergo an amputation during the initial hospitalization. Among 390 patients with known 12-month outcome, 71 (18.2 %) had a major amputation or died ≤12 months of hospital discharge.
CONCLUSION: We found a low post-discharge clinic attendance and high post-discharge amputation and death rates among patients hospitalized with DFUs. Interventions to increase access to outpatient DFU care are needed and could prevent amputations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Journal of diabetes and its complications - 36(2022), 10 vom: 15. Okt., Seite 108283 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mahgoub, Umnia [VerfasserIn] |
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| Links: |
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| Themen: |
Amputations |
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| Anmerkungen: |
Date Completed 04.10.2022 Date Revised 02.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jdiacomp.2022.108283 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345808452 |
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| 245 | 1 | 0 | |a Outpatient clinic attendance and outcomes among patients hospitalized with diabetic foot ulcers |
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| 500 | |a Date Revised 02.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: There are limited data on post-hospital discharge clinic attendance rates and outcomes among patients with diabetic foot ulcers (DFUs) | ||
| 520 | |a METHODS: Retrospective study of patients hospitalized with a DFU from 2016 to 2019 in a large public hospital. We measured rates and predictors of clinic attendance with providers involved with DFU care within 30 days of hospital discharge ("30-day post-discharge clinic attendance"). Log-binomial regression was used to estimate risk ratios (RR) and 95 % confidence intervals (CI) | ||
| 520 | |a RESULTS: Among 888 patients, 60.0 % were between 45 and 64 years old, 80.5 % were Black, and 24.1 % were uninsured. Overall, 478 (53.8 %) attended ≥1 30-day post-discharge clinic appointment. Initial hospital outcomes were associated with clinic attendance. For example, the RR of 30-day post-discharge clinic attendance was 1.39 (95%CI 1.19-1.61) among patients who underwent a major amputation compared to patients with DFUs without osteomyelitis and did not undergo an amputation during the initial hospitalization. Among 390 patients with known 12-month outcome, 71 (18.2 %) had a major amputation or died ≤12 months of hospital discharge | ||
| 520 | |a CONCLUSION: We found a low post-discharge clinic attendance and high post-discharge amputation and death rates among patients hospitalized with DFUs. Interventions to increase access to outpatient DFU care are needed and could prevent amputations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Amputations | |
| 650 | 4 | |a Clinic attendance | |
| 650 | 4 | |a Diabetic foot ulcers | |
| 700 | 1 | |a Magee, Matthew J |e verfasserin |4 aut | |
| 700 | 1 | |a Heydari, Maryam |e verfasserin |4 aut | |
| 700 | 1 | |a Choudhary, Muaaz |e verfasserin |4 aut | |
| 700 | 1 | |a Santamarina, Gabriel |e verfasserin |4 aut | |
| 700 | 1 | |a Schenker, Mara |e verfasserin |4 aut | |
| 700 | 1 | |a Rajani, Ravi |e verfasserin |4 aut | |
| 700 | 1 | |a Umpierrez, Guillermo E |e verfasserin |4 aut | |
| 700 | 1 | |a Fayfman, Maya |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Howard H |e verfasserin |4 aut | |
| 700 | 1 | |a Schechter, Marcos C |e verfasserin |4 aut | |
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