Effectiveness of fast-track pathway for diabetic foot ulcerations
| العنوان: | Effectiveness of fast-track pathway for diabetic foot ulcerations |
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| المؤلفون: | Alberto Piaggesi, Anna Rita Aleandri, Chris Manu, Kristien Van Acker, Juan Pedro Sánchez-Ríos, Víctor Rodriguez Saenz De Buruaga, Michela Di Venanzio, Luigi Uccioli, Claas Lüedemann, Jérôme Guillaumat, Valentina Izzo, José Luis García-Klepzig, Marco Meloni, Micheal Edmonds, Laura Giurato, Raju Ahluwalia, Benjamin Bouillet, Julien Vouillarmet, José Luis Lázaro-Martínez, Elisabetta Iacopi |
| المصدر: | Acta Diabetologica |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Multivariate analysis, Healing, Endocrinology, Diabetes and Metabolism, Limb salvage, 030209 endocrinology & metabolism, Type 2 diabetes, Amputation, Surgical, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Abscess, Foot Ulcer, Ulcer, Aged, Aged, 80 and over, business.industry, Diabetes, General Medicine, Middle Aged, Early referral, medicine.disease, Wound care, Diabetic foot, Diabetic Foot, Diabetes Mellitus, Type 2, Original Article, Fast track, business |
| الوصف: | Aim To investigate the effectiveness of fast-track pathway (FTP) in the management of diabetic foot ulceration (DFU) after 2 years of implementation. Methods The study group was composed of patients who referred to a specialized DF centre due to DFUs. Those were divided in two groups: early referral (ER) and late referral (LR) patients. According to FTP, ER were considered patients who referred after 2 weeks in the case of uncomplicated non-healing ulcers (superficial, not infected, not ischemic), within 4 days in the case of complicated ulcers (ischemic, deep, mild infection) and within 24 h in the case of severely complicated ulcers (abscess, wet gangrene, fever). Healing, healing time, minor and major amputation, hospitalization, and survival were evaluated. The follow-up was 6 months. Results Two hundred patients were recruited. The mean age was 70 ± 13 years, 62.5% were male, 91% were affected by type 2 diabetes with a mean duration of 18 ± 11 years. Within the group, 79.5% had ER while 20.5% had LR. ER patients showed increased rates of healing (89.9 vs. 41.5%, p = 0.001), reduced healing time (10 vs. 16 weeks, p = 0.0002), lower rates of minor (17.6 vs. 75.6%, p p p = 0.001), and mortality (4.4 vs. 19.5%, p = 0.02) in comparison to LR. At multivariate analysis, ER was an independent predictor of healing, while LR was an independent predictor for minor and major amputation and hospitalization. Conclusion After the FTP implementation, less cases of LR were reported in comparison to ER. ER was an independent predictor of positive outcomes such as healing, healing time, limb salvage, hospitalization, and survival. |
| تدمد: | 1432-5233 0940-5429 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0027d857b9231e8d6a4be5ddb153bebeTest https://doi.org/10.1007/s00592-021-01721-xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0027d857b9231e8d6a4be5ddb153bebe |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14325233 09405429 |
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