New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation

NewsBot · Jul 16, 2010

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Press Release:
New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation
Research Results to be Presented at APMA's 98th Annual Scientific Meeting

Essential foot care by a podiatrist has now been statistically proven to reduce hospitalization and amputation in adults with diabetes, according to a first of its kind study conducted by Thomson Reuters. The study will be presented by Vickie R. Driver, MS, DPM, during the American Podiatric Medical Association's (APMA) 98th Annual Scientific Meeting in Seattle, July 15-18, 2010. The presentation will highlight the dramatic impact that as few as one visit to a podiatrist can have on patients with diabetes.

The study, which was sponsored by APMA, examined records for more than 32,000 patients with diabetes, ages 18-64, and compared health and risk factors for those who had podiatry visits to those who did not. Researchers found that care by a podiatric physician (defined as at least one preventative, pre-ulcer visit) was associated with a nearly 29 percent lower risk of amputation and 24 percent lower risk of hospitalization. Diabetic foot complications are the leading cause of non-traumatic lower limb amputation in the U.S.

"The results of this study undeniably support visits to a podiatrist being critical to a diabetes patient's health and well being," said APMA member Dr. Driver. "No longer can care by a podiatrist be considered optional for those with diabetes, and the earlier a podiatrist is included in the diabetes management team, the better quality of life for the patient and greater health-care cost savings for all involved. This study clearly allows us to understand both the clinical and economic value of a podiatrist, in the team approach to saving diabetic patients' feet."

The study was conducted using Thomson Reuters' MarketScan Research Databases, which house fully integrated, de-identified health-care claims data extensively used by researchers to understand health economics and outcomes. Studies based on MarketScan data have been published in more than 130 peer-reviewed articles in the past five years.

Lead researcher Teresa Gibson, PhD, director of health outcomes research at Thomson Reuters said, "Using the MarketScan Databases, we statistically matched patients with diabetes and foot ulcers who had visited a podiatrist with like patients who had not. The analysis of the data indicates that patients who had seen a podiatrist in the year prior to the onset of a foot ulcer had significantly lower rates of any amputation and hospitalization than those who had not."
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pule · Jul 21, 2010

I guess this research will be of help to me as im charged with the responsibility of doing a "mini" research to stastically determine the number of diabetic patients who are amputated at the hospital where I work.

NewsBot · Jul 26, 2010

Here is the abstract of the research that was the subject of the above press release:

The Impact of a Podiatric Lead Limb Preservation Team on Disease Outcomes and Risk Prediction in the Diabetic Lower Extremity
A Retrospective Cohort Study
Vickie R. Driver, Russell A. Goodman, Matteo Fabbi, Michael A. French and Charles A. Andersen
Journal of the American Podiatric Medical Association
Volume 100 Number 4 235-241 2010

Background: We used a model of lower-extremity ulceration to determine the impact of a podiatric lead limb preservation team on identified relationships among risk factors, predictors of ulceration, amputation, and clinical outcomes of lower-extremity disease in patients with diabetes mellitus.

Methods: A total of 485 patients with diabetes mellitus were randomly selected from the diabetic population and included in this retrospective cohort study. Patients were then stratified into two groups: those who received specialty podiatric medical care and those who did not. Data covering a 5-year period were collected using electronic medical records and chart abstraction to capture detailed treatment characteristics, ulcer status, and surgical outcomes.

Results: Overall, the frequencies of inpatient and outpatient encounters and the durations of hospital stays were significantly greater with increasing wound depth and in the presence of infection. In addition, the overall ulcer incidence was greater in patients with callus (34.3% versus 10.3%, P < .0001) with and without neuropathy (20.4% and 4.1%, P < .0001). Among patients treated in a specialty multidiscipline podiatric medical setting, the proportion of all amputations that were "minor" was significantly increased (33.7% versus 67.3%, P = .0006), and survival was significantly improved (19.5% versus 7.7%, P < .0001).

Conclusions: Early identification of individuals at increased risk for lower-extremity ulceration and subsequent referral for advanced multidiscipline podiatric medical specialty care may decrease rates of ulceration and proximal amputation and improve survival in patients with diabetes mellitus who are at high risk for ulceration and limb loss.
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NewsBot · Aug 21, 2010

Receipt of Care and Reduction of Lower Extremity Amputations in a Nationally Representative Sample of U.S. Elderly.
Sloan FA, Feinglos MN, Grossman DS.
Health Serv Res. 2010 Aug 16. [Epub ahead of print]

Objective. To determine effectiveness of receipt of care from podiatrist and lower extremity clinician specialists (LEC specialists) on diabetes mellitus (DM)-related lower extremity amputation. Data Sources. Medicare 5 percent sample claims, 1991-2007.

Study Design. Individuals with DM-related lower extremity complications (LECs) were followed 6 years. Visits with podiatrists, LEC specialists, and other health professionals were tracked to ascertain whether receipt of such care reduced the hazards of an LEC amputation.

Data Collection. Individuals were stratified based on disease severity, Stage 1-neuropathy, paresthesia, pain in feet, diabetic amyotrophy; Stage 2-cellutis, charcot foot; Stage 3-ulcer; Stage 4-osteomyelitis, gangrene.

Principal Findings. Half the LEC sample died within 6 years. More severe lower extremity disease increased risk of death and amputation. Persons visiting a podiatrist and an LEC specialist within a year before developing all stage complications were between 31 percent (ulceration) and 77 percent (cellulitis and charcot foot) as likely to undergo amputation compared with individuals visiting other health professionals.

Conclusions. Individuals with an LEC had high mortality. Visiting both a podiatrist and an LEC specialist in the year before LEC diagnosis was protective of undergoing lower extremity amputation, suggesting a benefit from multidisciplinary care.
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New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation

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New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation

NewsBot The Admin that posts the news.

pule Welcome New Poster

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Exam Topics Free Essentials: How to Navigate Your Study Material

A Finite Element Study of Different Shoe Soles

Pilot Study Quantifies Proprioceptive Insole

Studying the ostrich's foot to help design running shoes

TREADON study in plantar heel pain

International student studying podiatry

Case Study advice - What has gone wrong?

Share This Page

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