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Postoperative healing in the diabetic foot is impacted by discharge destination
The aim of this study was to evaluate the impact of discharge destination on diabetes‐related limb salvage surgery outcomes post‐hospitalisation. This was a single‐centre, observational, descriptive study of 175 subjects with diabetes who underwent limb salvage surgery of a minor foot amputation or...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450796/ https://www.ncbi.nlm.nih.gov/pubmed/33938106 http://dx.doi.org/10.1111/iwj.13567 |
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author | Burmeister, Rebecca A. Jarocki, Christine Holmes, Crystal M. Rothenberg, Gary M. Munson, Michael E. Schmidt, Brian M. |
author_facet | Burmeister, Rebecca A. Jarocki, Christine Holmes, Crystal M. Rothenberg, Gary M. Munson, Michael E. Schmidt, Brian M. |
author_sort | Burmeister, Rebecca A. |
collection | PubMed |
description | The aim of this study was to evaluate the impact of discharge destination on diabetes‐related limb salvage surgery outcomes post‐hospitalisation. This was a single‐centre, observational, descriptive study of 175 subjects with diabetes who underwent limb salvage surgery of a minor foot amputation or wide incision and debridement for an acutely infected diabetic foot ulcer (DFU). Comparisons were made between subjects discharged home vs a skilled nursing facility (SNF) for 12 months postoperatively. Univariate, multivariate, and time‐to‐event analyses were performed. The SNF discharge group (n = 40) had worse outcomes with longer healing time (P = .022), more rehospitalisations requiring a podiatry consult (P = .009), increase of subsequent ipsilateral major lower‐extremity amputation (P = .028), and a higher mortality rate (P = .012) within the 12‐month postoperative period. There was no significant difference between the cohorts in surgically cleared osteomyelitis (P = .8434). The Charlson Comorbidity Index values for those discharged home and those in a short‐term nursing facility were similar (P = .3819; home [Formula: see text] =5.33 ± 2.84 vs SNF [Formula: see text] =5.75 ± 2.06). The planned discharge destination after limb salvage surgery among people with an acutely infected DFU should be an added risk factor for healing outcomes. Patients discharged to SNFs experience additional morbidity and mortality compared with patients discharged home post‐hospitalisation. |
format | Online Article Text |
id | pubmed-8450796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-84507962021-09-27 Postoperative healing in the diabetic foot is impacted by discharge destination Burmeister, Rebecca A. Jarocki, Christine Holmes, Crystal M. Rothenberg, Gary M. Munson, Michael E. Schmidt, Brian M. Int Wound J Original Articles The aim of this study was to evaluate the impact of discharge destination on diabetes‐related limb salvage surgery outcomes post‐hospitalisation. This was a single‐centre, observational, descriptive study of 175 subjects with diabetes who underwent limb salvage surgery of a minor foot amputation or wide incision and debridement for an acutely infected diabetic foot ulcer (DFU). Comparisons were made between subjects discharged home vs a skilled nursing facility (SNF) for 12 months postoperatively. Univariate, multivariate, and time‐to‐event analyses were performed. The SNF discharge group (n = 40) had worse outcomes with longer healing time (P = .022), more rehospitalisations requiring a podiatry consult (P = .009), increase of subsequent ipsilateral major lower‐extremity amputation (P = .028), and a higher mortality rate (P = .012) within the 12‐month postoperative period. There was no significant difference between the cohorts in surgically cleared osteomyelitis (P = .8434). The Charlson Comorbidity Index values for those discharged home and those in a short‐term nursing facility were similar (P = .3819; home [Formula: see text] =5.33 ± 2.84 vs SNF [Formula: see text] =5.75 ± 2.06). The planned discharge destination after limb salvage surgery among people with an acutely infected DFU should be an added risk factor for healing outcomes. Patients discharged to SNFs experience additional morbidity and mortality compared with patients discharged home post‐hospitalisation. Blackwell Publishing Ltd 2021-05-02 /pmc/articles/PMC8450796/ /pubmed/33938106 http://dx.doi.org/10.1111/iwj.13567 Text en © 2021 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Burmeister, Rebecca A. Jarocki, Christine Holmes, Crystal M. Rothenberg, Gary M. Munson, Michael E. Schmidt, Brian M. Postoperative healing in the diabetic foot is impacted by discharge destination |
title | Postoperative healing in the diabetic foot is impacted by discharge destination |
title_full | Postoperative healing in the diabetic foot is impacted by discharge destination |
title_fullStr | Postoperative healing in the diabetic foot is impacted by discharge destination |
title_full_unstemmed | Postoperative healing in the diabetic foot is impacted by discharge destination |
title_short | Postoperative healing in the diabetic foot is impacted by discharge destination |
title_sort | postoperative healing in the diabetic foot is impacted by discharge destination |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450796/ https://www.ncbi.nlm.nih.gov/pubmed/33938106 http://dx.doi.org/10.1111/iwj.13567 |
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