Assessing the outcome of the management of diabetic foot ulcers using ulcer-related and person-related measures

摘要: OBJECTIVE —The purpose of this study was to compare different outcome measures in the audit management diabetic foot ulcers RESEARCH DESIGN AND METHODS —Data collected prospectively a consecutive cohort patients referred specialist multidisciplinary care clinic between 1 January 2000 and 31 December 2003 were analyzed. A single index ulcer selected for each patient classified according both Size (Area Depth), Sepsis, Arteriopathy, Denervation [S(AD)SAD] University Texas (UT) systems. Ulcer-related outcomes (healing, resolution by ipsilateral amputation or death, persisting unhealed) determined at 6 12 months compared with patient-related (survival, any amputation, being free from ulcer) months. RESULTS —In 449 (63.7% male, mean age 66.7 ± 13.2 years), 352 (78.4%) ulcers superficial [S(AD)SAD/UT grade 1] 134 these (38.1% 352) neither ischemic nor infected. total 183 (40.8% 449) clinically infected, peripheral arterial disease present 216 (48.1%). Seventeen (3.8%) lost follow-up excluded analysis. Of ulcers, 247 (55.0% 295 (65.7%) healed without months, respectively. Median (range) time healing 78 (7–364) days. all 5.8 8.0% resolved 6.2 10.9% death same points; 27.8 11.6% persisted unhealed. In contrast, revealed that only 202 (45.0%) alive, months. This group had 272 (1–358) days ulcer. 48 (10.7%) undergone some form 75 (16.7%) died. CONCLUSIONS —These data illustrate extent which ulcer-related may underestimate true morbidity mortality associated disease. It is suggested when attempts are made effectiveness centers, greater emphasis should be placed on measures.