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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...

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Autores principales: Burmeister, Rebecca A., Jarocki, Christine, Holmes, Crystal M., Rothenberg, Gary M., Munson, Michael E., Schmidt, Brian M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2021
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.
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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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