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Multidisciplinary management of diabetic foot infection associated with improved 8-year overall survival.
Vuorlaakso, Miska; Karèn, Verna; Kiiski, Juha; Lahtela, Jorma; Kaartinen, Ilkka.
Afiliación
  • Vuorlaakso M; Department of Musculoskeletal Surgery and Diseases, Clinic of Plastic and Reconstructive Surgery, Tampere University Hospital, Pirkanmaa Hospital District, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: miska.vuorlaakso@pirha.fi.
  • Karèn V; Department of Musculoskeletal Surgery and Diseases, Clinic of Plastic and Reconstructive Surgery, Tampere University Hospital, Pirkanmaa Hospital District, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: verna.karen@pirha.fi.
  • Kiiski J; Department of Musculoskeletal Surgery and Diseases, Clinic of Plastic and Reconstructive Surgery, Tampere University Hospital, Pirkanmaa Hospital District, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: juha.kiiski@pirha.fi.
  • Lahtela J; Department of Internal Medicine, Tampere University Hospital, Pirkanmaa Hospital District, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: jorma.lahtela@iki.fi.
  • Kaartinen I; Department of Musculoskeletal Surgery and Diseases, Clinic of Plastic and Reconstructive Surgery, Tampere University Hospital, Pirkanmaa Hospital District, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: ilkka.kaartinen@pirha.fi.
J Diabetes Complications ; 38(5): 108719, 2024 05.
Article en En | MEDLINE | ID: mdl-38574694
ABSTRACT

AIMS:

Diabetic foot syndrome is a global challenge best managed through multidisciplinary collaboration. This study aimed to investigate the effect of a systematic multidisciplinary team (MDT) on the overall survival and major amputation-free survival of hospitalized patients with diabetic foot infection (DFI).

METHODS:

This retrospective cohort study was conducted at Tampere University Hospital. Cohorts of hospitalized patients with DFI before and after the initiation of multidisciplinary wound ward were compared after an 8-year follow-up.

RESULTS:

Kaplan-Meier analysis revealed significantly higher overall survival in the post-MDT cohort (37.8 % vs 22.6 %, p < 0.05) in 8-year follow-up. Similarly, major amputation-free survival was superior in this cohort (31.8 % vs 16.9 %, p < 0.05). Additionally, early major amputation was associated with inferior overall survival (35.1 % vs 12.0 %, p < 0.05). In a multivariable Cox-regression analysis cohort (hazard ratio [HR] 1.38, 95 % confidence interval [CI95%] 1.01-1.87), early amputation (HR 1.64, CI95% 1.14-2.34) and diagnosed peripheral artery disease (HR 2.23, CI95% 1.61-3.09), congestive heart failure (HR 2.13, CI95% 1.47-3.08), or moderate kidney disease (HR 1.95, CI95% 1.34-2.84) were identified as significant risk factors affecting overall survival.

CONCLUSIONS:

After systematic MDT approach we found improved long-term overall and major amputation-free survival. Multidisciplinary approach is therefore highly recommended for managing patients hospitalized for DFI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Grupo de Atención al Paciente / Pie Diabético / Amputación Quirúrgica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Diabetes Complications Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Grupo de Atención al Paciente / Pie Diabético / Amputación Quirúrgica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Diabetes Complications Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos