SFEIES24 Poster Presentations Diabetes & Metabolism (68 abstracts)
A real-world, single-centre experience of vascular specialist input on the multidisciplinary diabetic foot round in a tertiary hospital – an observational study
Michael Lockhart , Ellen Young , Colm Kelly , Conor Cahill , Katie O’Shea , Lisa Reddington , Arunabai Pandian , Doireann Joyce , Sinéad Cremen , Muhammad Tubassam , Aonghus O’Loughlin , David Gallagher & Sean Dinneen
Galway University Hospitals, Galway, Ireland
Introduction: Multidisciplinary Foot Team (MDFT) input is a cornerstone of best-practice guidelines for the management of active diabetic foot disease (DFD). This study describes the experience of the inpatient multidisciplinary DFD ward round (DFR) in our hospital over two three-month periods, one year apart.
Methods: We prospectively captured data from the DFR in our hospital over two three-month periods, one year apart. This weekly DFR reviews inpatients with active DFD on a consults basis. During the earlier study period, no vascular surgical specialists were available to be in attendance at the time of the round. During the later study period, vascular surgeons were present on the DFR. The primary outcome measure was rate of amputation. Secondary measures included length of stay, microbiology and imaging investigations, vascular studies, HbA1c, diabetes classification and prior history of amputation and ulceration. Categorical data were compared using Chi-squared test. Numerical data were compared using Mann-Whitney U test.
Results: 24 individual patients who were admitted with a primary DFD-related complaint were reviewed on the DFR in the first three-month period. In the second three-month period one year later, there were 23 such reviews. There was a statistically significant increase in amputation rates between the time periods. There were 3 minor and 2 major amputations in the earlier period (1 patient underwent both a minor and major amputation during the admission). There were 10 minor and 0 major amputations in the later period. Average length of stay was not significantly different between the two groups.
Conclusions: The presence of vascular input on the DFR was associated with a significantly higher rate of minor amputations. We believe this change reflects prompt vascular input leading to timely definitive management. This study highlights the powerful role that a comprehensive MDFT assessment plays in altering patient outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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