Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study

Prompers, L.; Huijberts, M. S. P.; Apelqvist, Jan; Jude, E. B.; Piaggesi, Alberto; Баккер, К.; Edmonds, M.; Holstein, P.; Jirkovská, Alexandra; Mauricio, Dı́dac; Tennvall, Gunnel Ragnarson; Reike, Heinrich; Spraul, Maximilian; Uccioli, Luigi; Urbančič, V.; Acker, Kristien Van; Baal, Jeff Van; Merode, Frits van; Schaper, Nicolaas C.

doi:10.1111/j.1464-5491.2008.02445.x

Cited by 180 publications

(178 citation statements)

References 21 publications

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“…As described elsewhere, we found significant variations in clinical practice between centres. In particular, there were marked differences in the use of resources such as total contact casting and vascular imaging [20]. In addition, the relative prices and costs may vary between countries.…”

Section: Discussionmentioning

confidence: 99%

Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective data from the Eurodiale Study

et al. 2008

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Aims/hypothesis The aim of the present study was to investigate resource utilisation and associated costs in patients with diabetic foot ulcers and to analyse differences in resource utilisation between individuals with or without peripheral arterial disease (PAD) and/or infection. Methods Data on resource utilisation were collected prospectively in a European multicentre study. Data on 1,088 patients were available for the analysis of resource use, and data on 821 patients were included in the costing analysis. Costs were calculated for each patient by multiplying the country-specific direct and indirect unit costs by the number of resources used from inclusion into the study up to a defined endpoint. Country-specific costs were converted into purchasing power standards. Results Resource use and costs varied between outcome groups and between disease severity groups. The highest costs per patient were for hospitalisation, antibiotics, Diabetologia (2008) amputations and other surgery. All types of resource utilisation and costs increased with the severity of disease. The total cost per patient was more than four times higher for patients with infection and PAD at inclusion than for patients in the least severe group, who had neither. Conclusions/interpretation Important differences in resource use and costs were found between different patient groups. The costs are highest for individuals with both peripheral arterial disease and infection, and these are mainly related to substantial costs for hospitalisation. In view of the magnitude of the costs associated with inhospital stay, reducing the number and duration of hospital admissions seems an attractive option to decrease costs in diabetic foot disease.

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Section: Discussionmentioning

confidence: 99%

Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective data from the Eurodiale Study

et al. 2008

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“…Thus depending upon the characterization of a given arterial lesion, a diabetic patient with PAD may benefit from a surgery-first or an angioplasty-first approach. Most diabetics with critical ischemia have popliteal/tibial site of occlusion thus therapeutic option requires a surgical approach below-the-knee or bypass grafting [74] . A study conducted by Ciccone et al [75] evaluated the outcome of patients with diabetic foot who underwent angioplasty (PTA) revascularization.…”

Section: Table 8 Diabetic Foot Infection Classification Schemes: Infementioning

confidence: 99%

Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes

Tuttolomondo

Maida

Pinto

2015

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125

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“…Podiatrists should, along with Vascular Surgeons and Diabetologist, be at the forefront of these multidisciplinary teams to provide evidenced-based DFU management [14,15]. However, sizable differences in DFU healing rates (60–77%) and in the median number days to heal (78–241 days) have been reported [7,16–19]. …”

Section: Introductionmentioning

confidence: 99%

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

Messenger

Masoetsa

Hussain

et al. 2018

Diabetic Foot & Ankle

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Objective: This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods: Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first. Results: All data were analysed using IBM SPSS version 24 software. Data were collected from 230 patients with 335 DFUs. Most DFUs (67%) were present for <3 months from the time of the first podiatry appointment. A total of 56% of DFUs were classified as neuropathic. Most (72%) DFUs healed, with a median healing time of 52.0 days. Chronic kidney disease (p = 0.001), retinopathy (p = 0.03), smoking (p = 0.02), ulcer location (p = 0.03), peripheral arterial disease (PAD) (p = 0.004) and osteomyelitis (p = 0.05) were found to have a meaningful association with DFU outcome. The number of days to heal was associated with ulcer classification (p = 0.005), bacterial infection (p = 0.002), osteomyelitis (p = < 0.001) and PAD (p = < 0.001). Conclusions: The incidence of new DFUs in our tertiary clinic is 3.4%. The incidence of diabetic foot ulceration, days to heal, healing rate and the risk factors influencing healing are in accordance with other multidisciplinary facilities with podiatry input.

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Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study

Cited by 180 publications

References 21 publications

Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective data from the Eurodiale Study

Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective data from the Eurodiale Study

Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

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