O'Rourke, Ian; Heard, Sam; Treacy, John; Gruen, Russell; Whitbread, Cherie

Author(s)

O'Rourke, Ian

Heard, Sam

Treacy, John

Gruen, Russell

Whitbread, Cherie

Publication Date

2002-04

Abstract

The foot complications of diabetes are severe, disabling, costly and common in the Northern Territory. An understanding of the pathogenesis, the disease spectrum and treatment efficacy, however, is poor. The patterns of disease are documented in the present study; factors associated with good and poor outcomes are identified; and improved management strategies are proposed. All patients presenting to the High Risk Foot Service at Royal Darwin Hospital between March 1997 and March 2000 were included in the present study, and details regarding the status of their feet, their demographics, their treatment and their outcomes were recorded prospectively. Logistic regression analysis was undertaken to determine associations between factors of interest and outcomes of healing and amputation. One hundred and twenty-six patients were recorded, 41% of whom had neuropathic ulcers and 63% of whom had severe disease at presentation. Two types of diabetic foot pathology were recognized that are not usually classified: acute injury without neuropathy (10%) and deep soft tissue infection alone (9%).Thirty-seven percent and 23% of patients required minor and major amputations, respectively. The total number of hospital bed-days was 5813. Total contact casting was associated with good healing rates in 16 patients. Major amputation was associated with ischaemia, severe disease at presentation and increasing age. Patterns of diabetic foot disease which are not commonly recognized are described in the present study; the severity and cost of the problem are documented; and some factors which lead to poor outcome, such as late presentation, are identified. Attention should be paid, through a multidisciplinary team, to timely referral from primary care, patient education, total contact casts and appropriate revascularization.

Affiliation

Flinders University Northern Territory Clinical School and Royal Darwin Hospital, Darwin, Northern Territory, Australia. ti_orourke@bigpond.com.

Citation

ANZ journal of surgery 2002-04; 72(4): 282-6

ISSN

1445-1433

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/11982517/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/6811

MESH subject

Amputation

Diabetic Foot

Diabetic Neuropathies

Female

Foot

Foot Ulcer

Gangrene

Humans

Male

Middle Aged

Peripheral Nervous System Diseases

Risk Assessment

Severity of Illness Index

Treatment Outcome

Title

Risks to feet in the top end: outcomes of diabetic foot complications.

Type of document

Journal Article

Entity Type

Publication

Author(s)	O'Rourke, Ian Heard, Sam Treacy, John Gruen, Russell Whitbread, Cherie
Publication Date	2002-04
Abstract	The foot complications of diabetes are severe, disabling, costly and common in the Northern Territory. An understanding of the pathogenesis, the disease spectrum and treatment efficacy, however, is poor. The patterns of disease are documented in the present study; factors associated with good and poor outcomes are identified; and improved management strategies are proposed. All patients presenting to the High Risk Foot Service at Royal Darwin Hospital between March 1997 and March 2000 were included in the present study, and details regarding the status of their feet, their demographics, their treatment and their outcomes were recorded prospectively. Logistic regression analysis was undertaken to determine associations between factors of interest and outcomes of healing and amputation. One hundred and twenty-six patients were recorded, 41% of whom had neuropathic ulcers and 63% of whom had severe disease at presentation. Two types of diabetic foot pathology were recognized that are not usually classified: acute injury without neuropathy (10%) and deep soft tissue infection alone (9%).Thirty-seven percent and 23% of patients required minor and major amputations, respectively. The total number of hospital bed-days was 5813. Total contact casting was associated with good healing rates in 16 patients. Major amputation was associated with ischaemia, severe disease at presentation and increasing age. Patterns of diabetic foot disease which are not commonly recognized are described in the present study; the severity and cost of the problem are documented; and some factors which lead to poor outcome, such as late presentation, are identified. Attention should be paid, through a multidisciplinary team, to timely referral from primary care, patient education, total contact casts and appropriate revascularization.
Affiliation	Flinders University Northern Territory Clinical School and Royal Darwin Hospital, Darwin, Northern Territory, Australia. ti_orourke@bigpond.com.
Citation	ANZ journal of surgery 2002-04; 72(4): 282-6
ISSN	1445-1433
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/11982517/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/6811
MESH subject	Amputation Diabetic Foot Diabetic Neuropathies Female Foot Foot Ulcer Gangrene Humans Male Middle Aged Peripheral Nervous System Diseases Risk Assessment Severity of Illness Index Treatment Outcome
Title	Risks to feet in the top end: outcomes of diabetic foot complications.
Type of document	Journal Article
Entity Type	Publication

Risks to feet in the top end: outcomes of diabetic foot complications.

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