Evaluating the impact of an interdisciplinary integrated limb preservation service operating concurrently with a single-specialty service.

IF 2.5 3区医学 Q1 ORTHOPEDICS Journal of Foot and Ankle Research Pub Date : 2024-04-13 DOI:10.1002/jfa2.12013

Sebouh Bazikian, Alyssa J. Pyun, Hanke Zheng, William V Padula, Tanzim Khan, Kenneth Ziegler, Laura Shin, Gregory A Magee, Vincent L Rowe, David G. Armstrong

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Abstract

BACKGROUND This study examined the efficacy of an interdisciplinary limb preservation service (LPS) in improving surgical outcomes for diabetic foot ulcer (DFU) patients compared to traditional care. METHODS Data from January 1, 2017 to September 30, 2020 were retrospectively reviewed. An interdisciplinary LPS clinic began on August 1, 2018, coexisting with a preexisting single specialty service. Primary outcomes were major/minor amputation rates and ratios and hospital length of stay. Surgical endpoints pre- and post-LPS launch were compared. RESULTS Among 976 procedures for 731 unique DFU patients, most were male (80.4%) and Hispanic (89.3%). Patient demographics were consistent before and after LPS initiation. Major amputation rates decreased by 45.5% (15.4%-8.4%, p = 0.001), with outpatient procedures increasing over 5-fold (3.3% pre-LPS to 18.7% post-LPS, p < 0.001). Hospital stay reduced from 10.1 to 8.5 days post-LPS (p < 0.001). The major to minor amputation ratio declined from 22.4% to 12.7%. CONCLUSIONS The interdisciplinary LPS improved patient outcomes, marked by fewer major amputations and reduced hospital stays, suggesting the model's potential for broader application.

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评估跨学科综合肢体保护服务与单一专科服务同时运行的影响。

背景本研究探讨了与传统护理相比，跨学科肢体保护服务（LPS）在改善糖尿病足溃疡（DFU）患者手术疗效方面的功效。方法回顾性审查了 2017 年 1 月 1 日至 2020 年 9 月 30 日的数据。跨学科 LPS 诊所于 2018 年 8 月 1 日开诊，与原有的单一专科服务并存。主要结果为主要/次要截肢率和比率以及住院时间。对 LPS 启动前后的手术终点进行了比较。结果在 731 名独特的 DFU 患者的 976 例手术中，大多数为男性（80.4%）和西班牙裔（89.3%）。患者人口统计学特征在 LPS 启用前后保持一致。大截肢率降低了 45.5%（15.4%-8.4%，p = 0.001），门诊手术增加了 5 倍多（LPS 前为 3.3%，LPS 后为 18.7%，p < 0.001）。LPS 后，住院时间从 10.1 天缩短至 8.5 天（p < 0.001）。结论跨学科 LPS 改善了患者的预后，减少了大截肢，缩短了住院时间，表明该模式具有更广泛的应用潜力。

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来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.