title: Prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility: a cross-sectional prevalence study.
abstract: BACKGROUND
  Australian subacute inpatient rehabilitation facilities face significant challenges from the ageing population and the increasing burden of chronic disease. Foot disease complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute rehabilitation inpatient services, it seems imperative to investigate the prevalence of foot disease and foot disease risk factors in this population. The primary aim of this cross-sectional study was to determine the prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility.
  
  
  METHODS
  Eligible participants were all adults admitted at least overnight into a large Australian subacute inpatient rehabilitation facility over two different four week periods. Consenting participants underwent a short non-invasive foot examination by a podiatrist utilising the validated Queensland Health High Risk Foot Form to collect data on age, sex, medical co-morbidity history, foot disease risk factor history and clinically diagnosed foot disease complications and foot disease risk factors. Descriptive statistics were used to determine the prevalence of clinically diagnosed foot disease complications, foot disease risk factors and groups of foot disease risk factors. Logistic regression analyses were used to investigate any associations between defined explanatory variables and appropriate foot disease outcome variables.
  
  
  RESULTS
  Overall, 85 (88%) of 97 people admitted to the facility during the study periods consented; mean age 80 (±9) years and 71% were female. The prevalence (95% confidence interval) of participants with active foot disease was 11.8% (6.3 - 20.5), 32.9% (23.9 - 43.5) had multiple foot disease risk factors, and overall, 56.5% (45.9 - 66.5) had at least one foot disease risk factor. A self-reported history of peripheral neuropathy diagnosis was independently associated with having multiple foot disease risk factors (OR 13.504, p = 0.001).
  
  
  CONCLUSIONS
  This study highlights the potential significance of the burden of foot disease in subacute inpatient rehabilitation facilities. One in eight subacute inpatients were admitted with active foot disease and one in two with at least one foot disease risk factor in this study. It is recommended that further multi-site studies and management guidelines are required to address the foot disease burden in subacute inpatient rehabilitation facilities.
authors.affiliation: Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia ; School of Medicine, Flinders University, Adelaide, South Australia 5001 Australia.
authors.forename: Brenton J
authors.initials: BJ
authors.lastname: Earl
authors.affiliation: Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia ; Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032 Australia ; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland 4059 Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lazzarini
authors.affiliation: Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia.
authors.forename: Ewan M
authors.initials: EM
authors.lastname: Kinnear
authors.affiliation: Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032 Australia ; Griffith Health Institute, Behavioural Basis of Health, Griffith University, Brisbane, Queensland 4122 Australia.
authors.forename: Petrea L
authors.initials: PL
authors.lastname: Cornwell
keywords: Complication; Foot; Inpatient; Prevalence; Subacute