Improvement of diabetic foot care after the Implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study
Improvement of diabetic foot care after the Implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study
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DOI：
10.1016/j.diabres.2006.05.014
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发表时间：
2007-02-01
影响因子：
5.1
通讯作者：
De Bellis, Alessandra
中科院分区：
文献类型：
--
作者：
Anichini, Roberto;Zecchini, Franco;De Bellis, Alessandra
这项前瞻性研究的目的是评价糖尿病足国际共识（ICDF）在佩斯托亚地区实施的有效性（托斯卡纳，意大利），在接受筛查的人口百分比、住院率减少、和减少下肢截肢。这项研究进行了5年的时间，（1999-2003年），在一家地区综合医院，覆盖明确界定的相对固定的人口。综合社区发展框架的实施是在地区卫生保健一级与全科医生合作进行的，并在医院建立了一个多学科护理小组。本研究的数据库从DRG托斯卡纳数据库中提取，糖尿病足病变数据来源于佩斯托亚卫生保健区的数据评估中心，与糖尿病单位的临床记录交叉检查。观察到的糖尿病足病变总数和转诊至佩斯托亚的糖尿病科。实施后，糖尿病足病变住院总人数和临床住院时间减少。截肢总发生率从1999年的每10万居民10.7例下降到2000年的10.1例、2001年的2.7例、2002年的6.3例和2003年的6.24例。特别是，虽然大截肢的发生率随着时间的推移而下降，但小截肢的相对数量在最初几年有所增加，并在以后几年稳定在较高的比例。最后，而在1999年之前，大多数人从佩斯托亚地区被转介到托斯卡纳的糖尿病足问题的各个医院，在实施期间，几乎所有的被转介到糖尿病单位的佩斯托亚。这项研究显示了前瞻性数据收集的优势，表明，实施糖尿病足国际共识，可以改善糖尿病足部护理。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
The aim of this prospective study was to evaluate the efficacy of the implementation of the International Consensus on the Diabetic Foot (ICDF) in the area of Pistoia (Tuscany, Italy), in terms of percentage of population screened, reduction of hospitalization, and reduction of lower extremity amputations.The study was carried out over a 5-year period (1999-2003) in a district general hospital covering a clearly defined and relatively static population. The implementation of ICDF was performed at district health care level, in collaboration with general practitioners, and at the hospital with the establishment of a multidisciplinary care team. The database for this study was extracted from the DRG Tuscany database, and the diabetes foot lesion data source was taken from the Data Elaboration Centre of the Health Care District of Pistoia, cross-checked with the clinical records of the Diabetes Unit.In the period of the study, there was an increase in both the total number of diabetic foot lesions observed and the number of patients with diabetes referred for evaluation to the Diabetes Unit of Pistoia. Following implementation, the total number of hospitalizations for diabetic foot lesions and the duration of clinical stay were reduced. The total incidence of amputations per 100,000 inhabitants decreased from 10.7 in 1999, to 10.1 in 2000, 2.7 in 2001, 6.3 in 2002 and 6.24 in 2003. In particular, while the incidence of major amputations decreased over time, the relative number of minor amputations increased in the first years, stabilizing at a higher rate in later years. Finally, while before 1999 most people from the Pistoia area were referred to various hospitals in Tuscany for diabetic foot problems, during the implementation period almost all were referred to the Diabetic Unit of Pistoia.This study shows the advantages of prospective data collection, demonstrating that the implementation of the International Consensus on the Diabetic Foot can improve foot care in diabetes. (c) 2006 Elsevier Ireland Ltd. All rights reserved.