Dimitri Diacogiorgis MApplSc, Byron Matthew Perrin PhD, Michael Ian Charles Kingsley PhD
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The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Three-year retrospective medical record audit.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Large regional health service with catchment area of >250 000 people in regional Australia.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC).</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measures</h3>\n \n <p>Participant characteristics and acute CN assessment, diagnosis and management characteristics. Trends in characteristics were investigated according to rurality as measured by the Modified Monash Model (MMM) scale.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seventeen participants (20 presentations) of acute CN were identified. Mean age was 57.1 ± 10.8 years, with 11 female participants. Median duration to seek help was 31 (IQR 14–47) days. Total Contact Casting was undertaken for 85% of cases, with those who resided in MMM1-2 regions experienced significantly shorter time to TCC therapy compared to those residing in MMM3-7 regions (<i>U</i> = 3.0, <i>p</i> < 0.01). Resolution of acute CN with or without deformity occurred in 70% of cases.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Those who lived in smaller regional and rural communities were more likely to experience delayed access to gold standard treatment for acute CN. Regional models of care for acute CN should include activities to improve the knowledge of people at risk of acute CN about the condition and upskill regional health professionals for timely and local TCC therapy.</p>\n </section>\n </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13168","citationCount":"0","resultStr":"{\"title\":\"Assessment, diagnosis and management characteristics of people with acute Charcot neuro-osteoarthropathy in a regional Australian health service: A 3-year retrospective audit\",\"authors\":\"Dimitri Diacogiorgis MApplSc, Byron Matthew Perrin PhD, Michael Ian Charles Kingsley PhD\",\"doi\":\"10.1111/ajr.13168\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>Acute Charcot neuro-osteoarthropathy (CN) is highly destructive, causing bone and joint damage that can result in devastating structural changes to the foot. The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Three-year retrospective medical record audit.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>Large regional health service with catchment area of >250 000 people in regional Australia.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Participants</h3>\\n \\n <p>People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main Outcome Measures</h3>\\n \\n <p>Participant characteristics and acute CN assessment, diagnosis and management characteristics. 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Assessment, diagnosis and management characteristics of people with acute Charcot neuro-osteoarthropathy in a regional Australian health service: A 3-year retrospective audit
Objective
Acute Charcot neuro-osteoarthropathy (CN) is highly destructive, causing bone and joint damage that can result in devastating structural changes to the foot. The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service.
Design
Three-year retrospective medical record audit.
Setting
Large regional health service with catchment area of >250 000 people in regional Australia.
Participants
People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC).
Main Outcome Measures
Participant characteristics and acute CN assessment, diagnosis and management characteristics. Trends in characteristics were investigated according to rurality as measured by the Modified Monash Model (MMM) scale.
Results
Seventeen participants (20 presentations) of acute CN were identified. Mean age was 57.1 ± 10.8 years, with 11 female participants. Median duration to seek help was 31 (IQR 14–47) days. Total Contact Casting was undertaken for 85% of cases, with those who resided in MMM1-2 regions experienced significantly shorter time to TCC therapy compared to those residing in MMM3-7 regions (U = 3.0, p < 0.01). Resolution of acute CN with or without deformity occurred in 70% of cases.
Conclusions
Those who lived in smaller regional and rural communities were more likely to experience delayed access to gold standard treatment for acute CN. Regional models of care for acute CN should include activities to improve the knowledge of people at risk of acute CN about the condition and upskill regional health professionals for timely and local TCC therapy.
期刊介绍:
The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.