Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work.
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| Title: | Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work. |
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| Alternate Title: | Disminución de las amputaciones en pacientes diabéticos en un área de salud a lo largo de 15 años. Resultados de la implantación de una vía clínica intrahospitalaria y una consulta externa del pie diabético. |
| Authors: | de Alcalá Martínez- Gómez, Diego1 diegoa.martinez@carm.es, Moreno-Carrillo, M. Angeles1, Campillo-Soto, Alvaro1, Carrillo-García, Andrés1, Aguayo-Albasini, José Luís1 |
| Source: | Revista Española de Quimioterapia. sep2014, Vol. 27 Issue 3, p170-179. 10p. |
| Subjects: | FOOT amputation, AMPUTATION, PEOPLE with diabetes, DIABETES risk factors, FOOT care, SPANIARDS, PREVENTION, HEALTH |
| Abstract (English): | Objective. To assess changes in diabetic lower-extremity amputations (LEA) rates in a defined population over a 15-year period, following a multidisciplinary approach including a critical pathway in an inpatient setting with standardized preoperative and postoperative care, as well as in an outpatient setting through the establishment of a diabetic foot clinic. Methods. This is a study of the incidence and types of LEAs performed in patients with diabetic foot disease complicated admitted to Morales Meseguer Hospital (Murcia, Spain), a large district general hospital, before (1998-2000) and after (2001-2012) of the introduction of better organized diabetes foot care. Hospital and clinic characteristics to the success of the programme are described. All cases of LEA in diabetic patients (1998-2012) within the area were identified by ICD-9-Clinical modification (CM) diagnostic codes. A chi square test was used to compare the frequency and level of amputations. Results. Over all inpatients with diabetes admitted with foot infections and gangrene, there was a significant decrease in the proportion of total major amputations (47%) and elective major amputations (66%) (p<0.001). The incidence of total major amputations rates per 100.000 of the general population fell with statistical significance (p=0.009). The biggest improvement in LEA incidence was seen in the reduction of major elective amputation with fell 60%, from 7.6 to 3.1 per 100,000 (p<0.001). Conclusions. Significant reductions in total and major amputations rates occurred over the 15-year period following improvements in foot care services included multidisciplinary teamwork (critical pathway and diabetic foot clinic). [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Introducción. El objetivo ha sido valorar los cambios en las tasas de amputaciones en pacientes diabéticos, durante un periodo de 15 años, al introducir una aproximación multidisciplinar en equipo, incluyendo una vía clínica intrahospitalaria, con estandarización de los cuidados pre y postoperatorios y posteriormente, la puesta en funcionamiento de una Clínica del Pie Diabético enfocada al paciente ambulatorio. Métodos. Se monitorizaron la incidencia y tipos de amputaciones realizadas en pacientes con pie diabético complicado, ingresados en el Hospital JM Morales Meseguer (Murcia, España), antes (1998-2000) y después (2001-2012) de la introducción de las modificaciones multidisciplinares destinadas a mejorar el proceso asistencial de los pacientes con pie diabético complicado. Se identificaron todos los casos de amputaciones en pacientes diabéticos mediante los códigos diagnósticos ICD-9-CM. Para el estudio estadístico se usó el test de la "chi cuadrado" para comparar la frecuencia y el nivel de las amputaciones. Resultados. Hubo una disminución significativa en la proporción de amputaciones mayores totales (incluyendo las amputaciones urgentes) (47%) y en las amputaciones mayores electivas (66%), siendo para ambas p<0,001, al considerar la totalidad de pacientes ingresados con infección del pie diabético y/ó gangrena. Al considerar la incidencia de amputaciones mayores por 100.000 habitantes, se objetivó una disminución estadísticamente significativa (p=0,009), siendo aún mayor dicha disminución al considerar la tasa de amputaciones mayores electivas con caída en torno al 60%, desde 7,6 a 3,1/100.000 (p<0,001). Conclusiones. Se concluye que la organización del proceso asistencial del pie diabético complicado, tanto intrahospitalariamente en los casos que precisan ingreso (vía clínica del Pie Diabético), como extra-hospitalariamente (Clínica del Pie Diabético) se asocia a reducciones significativas en las tasas de amputación mayor que se mantienen en el tiempo. [ABSTRACT FROM AUTHOR] |
| Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
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| Header | DbId: lth DbLabel: MedicLatina An: 98567735 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Disminución de las amputaciones en pacientes diabéticos en un área de salud a lo largo de 15 años. Resultados de la implantación de una vía clínica intrahospitalaria y una consulta externa del pie diabético. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22de+Alcalá+Martínez-+Gómez%2C+Diego%22">de Alcalá Martínez- Gómez, Diego</searchLink><relatesTo>1</relatesTo><i> diegoa.martinez@carm.es</i><br /><searchLink fieldCode="AR" term="%22Moreno-Carrillo%2C+M%2E+Angeles%22">Moreno-Carrillo, M. Angeles</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Campillo-Soto%2C+Alvaro%22">Campillo-Soto, Alvaro</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Carrillo-García%2C+Andrés%22">Carrillo-García, Andrés</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Aguayo-Albasini%2C+José+Luís%22">Aguayo-Albasini, José Luís</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Revista+Española+de+Quimioterapia%22">Revista Española de Quimioterapia</searchLink>. sep2014, Vol. 27 Issue 3, p170-179. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22FOOT+amputation%22">FOOT amputation</searchLink><br /><searchLink fieldCode="DE" term="%22AMPUTATION%22">AMPUTATION</searchLink><br /><searchLink fieldCode="DE" term="%22PEOPLE+with+diabetes%22">PEOPLE with diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22DIABETES+risk+factors%22">DIABETES risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22FOOT+care%22">FOOT care</searchLink><br /><searchLink fieldCode="DE" term="%22SPANIARDS%22">SPANIARDS</searchLink><br /><searchLink fieldCode="DE" term="%22PREVENTION%22">PREVENTION</searchLink><br /><searchLink fieldCode="DE" term="%22HEALTH%22">HEALTH</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Objective. To assess changes in diabetic lower-extremity amputations (LEA) rates in a defined population over a 15-year period, following a multidisciplinary approach including a critical pathway in an inpatient setting with standardized preoperative and postoperative care, as well as in an outpatient setting through the establishment of a diabetic foot clinic. Methods. This is a study of the incidence and types of LEAs performed in patients with diabetic foot disease complicated admitted to Morales Meseguer Hospital (Murcia, Spain), a large district general hospital, before (1998-2000) and after (2001-2012) of the introduction of better organized diabetes foot care. Hospital and clinic characteristics to the success of the programme are described. All cases of LEA in diabetic patients (1998-2012) within the area were identified by ICD-9-Clinical modification (CM) diagnostic codes. A chi square test was used to compare the frequency and level of amputations. Results. Over all inpatients with diabetes admitted with foot infections and gangrene, there was a significant decrease in the proportion of total major amputations (47%) and elective major amputations (66%) (p<0.001). The incidence of total major amputations rates per 100.000 of the general population fell with statistical significance (p=0.009). The biggest improvement in LEA incidence was seen in the reduction of major elective amputation with fell 60%, from 7.6 to 3.1 per 100,000 (p<0.001). Conclusions. Significant reductions in total and major amputations rates occurred over the 15-year period following improvements in foot care services included multidisciplinary teamwork (critical pathway and diabetic foot clinic). [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Introducción. El objetivo ha sido valorar los cambios en las tasas de amputaciones en pacientes diabéticos, durante un periodo de 15 años, al introducir una aproximación multidisciplinar en equipo, incluyendo una vía clínica intrahospitalaria, con estandarización de los cuidados pre y postoperatorios y posteriormente, la puesta en funcionamiento de una Clínica del Pie Diabético enfocada al paciente ambulatorio. Métodos. Se monitorizaron la incidencia y tipos de amputaciones realizadas en pacientes con pie diabético complicado, ingresados en el Hospital JM Morales Meseguer (Murcia, España), antes (1998-2000) y después (2001-2012) de la introducción de las modificaciones multidisciplinares destinadas a mejorar el proceso asistencial de los pacientes con pie diabético complicado. Se identificaron todos los casos de amputaciones en pacientes diabéticos mediante los códigos diagnósticos ICD-9-CM. Para el estudio estadístico se usó el test de la "chi cuadrado" para comparar la frecuencia y el nivel de las amputaciones. Resultados. Hubo una disminución significativa en la proporción de amputaciones mayores totales (incluyendo las amputaciones urgentes) (47%) y en las amputaciones mayores electivas (66%), siendo para ambas p<0,001, al considerar la totalidad de pacientes ingresados con infección del pie diabético y/ó gangrena. Al considerar la incidencia de amputaciones mayores por 100.000 habitantes, se objetivó una disminución estadísticamente significativa (p=0,009), siendo aún mayor dicha disminución al considerar la tasa de amputaciones mayores electivas con caída en torno al 60%, desde 7,6 a 3,1/100.000 (p<0,001). Conclusiones. Se concluye que la organización del proceso asistencial del pie diabético complicado, tanto intrahospitalariamente en los casos que precisan ingreso (vía clínica del Pie Diabético), como extra-hospitalariamente (Clínica del Pie Diabético) se asocia a reducciones significativas en las tasas de amputación mayor que se mantienen en el tiempo. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 170 Subjects: – SubjectFull: FOOT amputation Type: general – SubjectFull: AMPUTATION Type: general – SubjectFull: PEOPLE with diabetes Type: general – SubjectFull: DIABETES risk factors Type: general – SubjectFull: FOOT care Type: general – SubjectFull: SPANIARDS Type: general – SubjectFull: PREVENTION Type: general – SubjectFull: HEALTH Type: general Titles: – TitleFull: Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: de Alcalá Martínez- Gómez, Diego – PersonEntity: Name: NameFull: Moreno-Carrillo, M. Angeles – PersonEntity: Name: NameFull: Campillo-Soto, Alvaro – PersonEntity: Name: NameFull: Carrillo-García, Andrés – PersonEntity: Name: NameFull: Aguayo-Albasini, José Luís IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: sep2014 Type: published Y: 2014 Identifiers: – Type: issn-print Value: 02143429 Numbering: – Type: volume Value: 27 – Type: issue Value: 3 Titles: – TitleFull: Revista Española de Quimioterapia Type: main |
| ResultId | 1 |
