Diabetic foot complications are a significant health problem, requiring complex, multidisciplinary care to improve patient outcomes. Up to 25% of people with diabetes will develop a foot ulcer in their lives1, more than half of all foot ulcers will become infected and require hospitalization and 20% will require a lower extremity amputation2. Current guidelines are unequivocal that management is best done in a team approach. This study examines the outcomes of a new inpatient diabetes foot service (DFS) in a tertiary teaching hospital in the Western region of Melbourne.
Methods: A retrospective review of inpatient records from 1/3/11 – 31/12/12 examining clinical outcomes and length of stay of patients admitted with diabetic foot ulceration (DFU).
Results: 174 patients (272 episodes) due to a DFU were admitted during the audit review period (1/3/11 – 12/12/12) which displays a reduction from the previous comparative period (1/1/09-12/12/10) with 278 patients (348 episodes). The DFS demographic demonstrates 85% had type 2 diabetes mellitus, (62.6% treated with Insulin) with mean duration of diabetes of 17.8 years. The majority of patients had a history of previous amputations and ulcerations (62.9 and 76.6 % respectively) and significant diabetes complications. Compared to previous years (2010-2011) there was a reduction in length of stay in people with DFU. Length of stay was 20.00 days (2010) prior to the introduction of DFS and has been reduced to 16.28 days. Major amputations have reduced from 23 (2009-2010) to 12 (2011-2012), however minor amputations have risen from 83 to 104.
The DFS has been associated with improved patient outcomes and a significant reduction on the length of stay and reduced major amputations. Our data supports the development of co-ordinated DFS for other public hospitals.