The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study
BackgroundThis study aims to describe the trends in the severity and treatment modality of patients with diabetic foot ulcer (DFU) at a single tertiary referral center in Korea over the last 10 years and compare the outcomes before and after the introduction of a multidisciplinary diabetic foot team...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Diabetes Association
2018-04-01
|
| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-42-308.pdf |
| _version_ | 1811277325825736704 |
|---|---|
| author | Choong Hee Kim Jun Sung Moon Seung Min Chung Eun Jung Kong Chul Hyun Park Woo Sung Yoon Tae Gon Kim Woong Kim Ji Sung Yoon Kyu Chang Won Hyoung Woo Lee |
| author_facet | Choong Hee Kim Jun Sung Moon Seung Min Chung Eun Jung Kong Chul Hyun Park Woo Sung Yoon Tae Gon Kim Woong Kim Ji Sung Yoon Kyu Chang Won Hyoung Woo Lee |
| author_sort | Choong Hee Kim |
| collection | DOAJ |
| description | BackgroundThis study aims to describe the trends in the severity and treatment modality of patients with diabetic foot ulcer (DFU) at a single tertiary referral center in Korea over the last 10 years and compare the outcomes before and after the introduction of a multidisciplinary diabetic foot team.MethodsIn this retrospective observational study, electronic medical records of patients from years 2002 to 2015 at single tertiary referral center were reviewed. Based on the year of first admission, patients were assigned to a group either before or after the year 2012, the year the diabetes team launched.ResultsOf the 338 patients with DFU, 229 were first admitted until the year 2011 (group A), while 109 were first admitted since the year 2012 (group B). Mean age was higher in group B, and ulcer size was larger than those of group A. Whereas duration of diabetes was longer in group B, glycemic control was improved (mean glycosylated hemoglobin, 9.48% vs. 8.50%). The proportion of minor lower extremity amputation (LEA) was increased, but length of hospital stay was decreased (73.7±79.6 days vs. 39.8±36.9 days). As critical ischemic limb increased, the proportion of major LEA was not decreased.ConclusionImproved glycemic control, multidisciplinary strategies with prompt surgical treatment resulted in reduced length of hospital stay, but these measures did not reduce major LEAs. The increase in critical ischemic limb may have played a role in the unexpected outcome, and may suggest the need for increased vascular intervention strategies in DFU treatment. |
| first_indexed | 2024-04-13T00:14:53Z |
| format | Article |
| id | doaj.art-858a302eaa21444792349c62436cd841 |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-04-13T00:14:53Z |
| publishDate | 2018-04-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-858a302eaa21444792349c62436cd8412022-12-22T03:10:59ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872018-04-0142430831910.4093/dmj.2017.0076The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center StudyChoong Hee Kim0Jun Sung Moon1Seung Min Chung2Eun Jung Kong3Chul Hyun Park4Woo Sung Yoon5Tae Gon Kim6Woong Kim7Ji Sung Yoon8Kyu Chang Won9Hyoung Woo Lee10Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDepartment of Nuclear Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDepartment of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Vascular Surgery, Department of Surgery, Yeungnam University College of Medicine, Daegu, .KoreaDepartment of Plastic Surgery, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Cardiology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, .KoreaBackgroundThis study aims to describe the trends in the severity and treatment modality of patients with diabetic foot ulcer (DFU) at a single tertiary referral center in Korea over the last 10 years and compare the outcomes before and after the introduction of a multidisciplinary diabetic foot team.MethodsIn this retrospective observational study, electronic medical records of patients from years 2002 to 2015 at single tertiary referral center were reviewed. Based on the year of first admission, patients were assigned to a group either before or after the year 2012, the year the diabetes team launched.ResultsOf the 338 patients with DFU, 229 were first admitted until the year 2011 (group A), while 109 were first admitted since the year 2012 (group B). Mean age was higher in group B, and ulcer size was larger than those of group A. Whereas duration of diabetes was longer in group B, glycemic control was improved (mean glycosylated hemoglobin, 9.48% vs. 8.50%). The proportion of minor lower extremity amputation (LEA) was increased, but length of hospital stay was decreased (73.7±79.6 days vs. 39.8±36.9 days). As critical ischemic limb increased, the proportion of major LEA was not decreased.ConclusionImproved glycemic control, multidisciplinary strategies with prompt surgical treatment resulted in reduced length of hospital stay, but these measures did not reduce major LEAs. The increase in critical ischemic limb may have played a role in the unexpected outcome, and may suggest the need for increased vascular intervention strategies in DFU treatment.https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-42-308.pdfAmputationDiabetic footLength of stayPatient care team |
| spellingShingle | Choong Hee Kim Jun Sung Moon Seung Min Chung Eun Jung Kong Chul Hyun Park Woo Sung Yoon Tae Gon Kim Woong Kim Ji Sung Yoon Kyu Chang Won Hyoung Woo Lee The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study Diabetes & Metabolism Journal Amputation Diabetic foot Length of stay Patient care team |
| title | The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study |
| title_full | The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study |
| title_fullStr | The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study |
| title_full_unstemmed | The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study |
| title_short | The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study |
| title_sort | changes of trends in the diagnosis and treatment of diabetic foot ulcer over a 10 year period single center study |
| topic | Amputation Diabetic foot Length of stay Patient care team |
| url | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-42-308.pdf |
| work_keys_str_mv | AT choongheekim thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT junsungmoon thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT seungminchung thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT eunjungkong thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT chulhyunpark thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT woosungyoon thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT taegonkim thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT woongkim thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT jisungyoon thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT kyuchangwon thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT hyoungwoolee thechangesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT choongheekim changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT junsungmoon changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT seungminchung changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT eunjungkong changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT chulhyunpark changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT woosungyoon changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT taegonkim changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT woongkim changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT jisungyoon changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT kyuchangwon changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy AT hyoungwoolee changesoftrendsinthediagnosisandtreatmentofdiabeticfootulcerovera10yearperiodsinglecenterstudy |