Timing of access to secondary healthcare services and lower extremity amputations in patients with diabetes: a case-control study

BMJ Open Diabetes Research & Care
Claire M BuckleyColin P Bradley

Abstract

To investigate the association between timing of patient access to secondary healthcare services for diabetes management and lower extremity amputation (LEA) among patients with diabetes. A case-control study was conducted in the secondary healthcare system in Ireland. Cases were 116 patients with diabetes who underwent a first major non-traumatic LEA between 2006 and 2012. Controls were 348 patients with diabetes, over 45 years, admitted to the same hospital as an emergency or electively, frequency-matched for gender, type of diabetes, and year. Data were collected for 7 years prior to the event year. ORs for LEA in patients with diabetes comparing early versus late referral from primary to secondary healthcare were calculated. Statistically significant risk factors associated with LEA in patients with diabetes included being single, chronic kidney disease, hypertension, and hyperglycemia. Documented retinopathy was a significant protective factor. In unconditional logistic regression analysis adjusted for potential confounders, there was no evidence of a reduced risk of LEA among patients referred earlier to secondary healthcare for diabetes management. Specialist referral may need to occur earlier than the 7-year cut-off use...Continue Reading

References

Jul 1, 1992·Diabetes Research and Clinical Practice·K E SussmanS F Albert
Apr 1, 1995·Diabetes Care·J V Selby, D Zhang
Feb 15, 2002·Lancet·Kenneth F Schulz, David A Grimes
Jul 10, 2004·Revista de saúde pública·Mônica Antar GambaLucila A C Vianna
Apr 20, 2005·Lancet·David A Grimes, Kenneth F Schulz
Nov 18, 2005·Lancet·Andrew J M BoultonJan Apelqvist
Aug 5, 2008·Social Science & Medicine·Emanuele Scafato For The Ilsa Working Group
Sep 19, 2009·Social Psychiatry and Psychiatric Epidemiology·Paul Corcoran, Aaron Nagar
Mar 11, 2011·Diabetic Medicine : a Journal of the British Diabetic Association·P W MoxeyP J Holt
Jul 29, 2011·Journal of Public Health·E M BurnsO D Faiz
Nov 22, 2011·Foot & Ankle International·Ellie Pinsker, Timothy R Daniels
Jan 1, 2008·The European Journal of General Practice·Carmel BrennanIvan J Perry
Feb 5, 2013·Journal of Vascular Surgery·Philip P GoodneyJohn D Birkmeyer
Apr 9, 2013·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Sheena McHughDiarmuid Quinlan

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Methods Mentioned

BETA
amputation

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