Likelihood of hospital admission up during foot ulcer episodes

(HealthDay)—Diabetic foot ulcer episodes are associated with an increased likelihood of all-cause inpatient admissions and death compared with periods after ulcer healing, according to a study published online Jan. 18 in Diabetes Research and Clinical Practice.

Brian J. Petersen, from Podimetrics in Somerville, Massachusetts, and colleagues examined data from the Medicare Limited Data Set from 2013 to 2019 to develop and validate an episode-of-care model for diabetic foot ulceration. Episodes of care were defined by clustering diabetic foot ulcer-related claims such that the longest time interval between consecutive claims in any cluster did not exceed a duration that was adjusted to match two well-established aspects of foot ulcer episodes: healing rate at 12 weeks and reulceration rate after healing.

The researchers found that in the two validation criteria using a clustering duration of seven weeks, the episode-of-care model had a minimum mean relative error of 4.2 percent. All-cause inpatient admissions were 2.8 times more likely during foot ulcer episodes compared with periods after healing, and death was 1.5 times more likely.

"Diabetic foot complications should be viewed not as an innocent bystander, but instead as an accomplice driving and exacerbating additional chronic complications not commonly thought to be associated with diabetic foot ulcers," a coauthor said in a statement. "This change in perspective requires us to take a comprehensive look at the patient beyond their diabetic foot in order to identify other complex chronic conditions that might affect them."

Several authors disclosed financial ties to Podimetrics, which partially funded the study.

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