Diabetic foot ulcers, infections significantly up burden of care
Grant H. Skrepnek, Ph.D., from the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues conducted a cross-sectional historical cohort analysis using the nationally representative U.S. 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 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, 2.1-fold increased odds of referral to another physician, 1.9-fold more visits in the past 12 months, and 1.4-fold longer time spend per visit with the physician, in multivariate analyses. For DFIs there were independent associations with 6.7-fold increased odds of direct emergency department referral or inpatient admission, and 1.5-fold more visits in the past 12 months.
"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.
One author disclosed financial ties to the pharmaceutical, medical device, and medical technology industries.
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