[After-care of patients with diabetic foot by general practitioners or special ambulatory care--effects on rate of amputation].
The impact of a diabetic foot clinic on amputations rates was assessed in 55 diabetic patients with foot lesions, consecutively treated in hospital at the medical department of the university of Düsseldorf. After discharge from the hospital, wound care was continued at home by a mobile nursing team, in conjunction with an outpatient diabetic foot clinic, until complete healing of the lesions after 86-91 days on average. About 18-30 months later, the patients were re-assessed: 39 of them had kept in touch with the foot clinic (0.83 visits per month), and 16 had not (0.09 visits of the foot clinic per month) and were cared for by their general practitioners. Both groups did not differ with regard to age, sex, duration of diabetes, prevalence of peripheral ischaemic vessels disease, mortality, and other items. The prevalence of patients with relapsing foot lesions was also similar in both groups. However, there was a significant difference in amputation rates, in that the patients under care of the foot clinical had only 21% amputations per relapsing patient as compared to 68% amputations in relapsing patients under care of general practitioners (p < 0.05). It is concluded that patients with relapsing diabetic foot lesions are less frequently amputated when cared for by a specialised diabetic outpatient footclinic, as compared to the care provided by general practitioners.
Diabetes-Fuss-Ambulanz, Heinrich-Heine-Universität Düsseldorf.
M
M
Partl
D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000671:Amputation, Surgical; D002423:Cause of Death; D017719:Diabetic Foot / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
Nachsorge von Patienten mit diabetischem Fuss durch Hausärzte oder Spezialambulanz--Auswirkungen auf die Amputationsrate.