PMID- 28657897
OWN - NLM
STAT- MEDLINE
DCOM- 20180501
LR  - 20191210
IS  - 1943-2720 (Electronic)
IS  - 0889-5899 (Linking)
VI  - 63
IP  - 6
DP  - 2017 Jun
TI  - A Retrospective Review of Adverse Events Related to Diabetic Foot Ulcers.
PG  - 30-33
AB  - The risk of adverse events (AEs) such as infection and amputation related to 
      diabetic foot ulcers (DFUs) has been studied, but less is known about rate of 
      other AEs such as falls. As part of a quality improvement project, AEs in 
      veterans with diabetes mellitus (DM) with and without a DFU were examined. 
      Demographic data including ICD-9 codes, AEs, and comorbidities for all patients 
      with a diagnosis of DM and/or DFU treated between 2009 and 2014 at the James A. 
      Haley Veterans' Hospital, Tampa, FL, were reviewed retrospectively utilizing the 
      Corporate Data Warehouse (CDW) database. Identifiable protected health 
      information data using patient scrambled social security numbers were collected 
      from the CDW to allow the longitudinal data to be linked at the unique patient 
      level. Descriptive statistics (eg, mean, standard deviation) were determined for 
      demographics, AE, and comorbidities. Adjusted models of AE association with DM 
      and DFU were analyzed using regression modeling via a statistical analysis 
      system. The models were adjusted for age, race, gender, marital status, and 
      comorbidities. Data extracted included individuals diagnosed with diabetes with a 
      DFU (n = 3238, average age 66.0 +/- 10.6 years) and diabetes without DFU (n= 41 
      324, average age 64.4 +/- 11.5 years). Participants were mostly Caucasian in both 
      the DFU and non-DFU cohorts (2655 [82.0%] and 32 269 [78.1%], respectively) and 
      male (3129 [96.6%] and 39 580 [95.8%], respectively). The most common 
      comorbidities in this population were peripheral vascular disease (PVD, 39.5%) 
      and peripheral neuropathy (PN, 23.2%). PVD was more common in veterans with 
      (39.5%) than without a DFU (9.2%). Compared to individuals with DM, those with DM 
      and DFU were significantly more likely to experience an infection (OR = 9.43; 95% 
      CI 8.54-10.4), undergo an amputation (OR = 7.40; 95% CI 6.16-8.89), or experience 
      a fracture (OR = 3.65; 95% CI 2.59-5.15) or fall (OR = 2.26; 95% CI 1.96-2.60) (P 
      <.01 for all variables). Although the increased risk of infection and amputation 
      among persons with DFUs has been documented, less is known about the rate of 
      falls and fractures. The current findings will serve as baseline data for future 
      implementation trials to reduce DFU-associated AEs, and clinicians may want to 
      consider expanding DFU patient education efforts to include fall risk.
FAU - Allen, Latricia
AU  - Allen L
FAU - Powell-Cope, Gail
AU  - Powell-Cope G
AD  - James A. Haley Veterans' Hospital, Tampa, FL.
FAU - Mbah, Alfred
AU  - Mbah A
AD  - James A. Haley Veterans' Hospital, Tampa, FL.
FAU - Bulat, Tatjana
AU  - Bulat T
AD  - James A. Haley Veterans' Hospital, Tampa, FL.
FAU - Njoh, Eni
AU  - Njoh E
AD  - James A. Haley Veterans' Hospital, Tampa, FL.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ostomy Wound Manage
JT  - Ostomy/wound management
JID - 8912029
MH  - Aged
MH  - Cohort Studies
MH  - Comorbidity
MH  - Diabetes Mellitus/therapy
MH  - Diabetic Foot/*therapy
MH  - Female
MH  - Foot Ulcer/*therapy
MH  - Humans
MH  - Infections/etiology
MH  - Male
MH  - Middle Aged
MH  - Quality Improvement
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Treatment Outcome
MH  - United States
MH  - United States Department of Veterans Affairs
MH  - Veterans/statistics & numerical data
MH  - Wound Healing
EDAT- 2017/06/29 06:00
MHDA- 2018/05/02 06:00
CRDT- 2017/06/29 06:00
PHST- 2017/06/29 06:00 [entrez]
PHST- 2017/06/29 06:00 [pubmed]
PHST- 2018/05/02 06:00 [medline]
PST - ppublish
SO  - Ostomy Wound Manage. 2017 Jun;63(6):30-33.