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Postoperative healing in the diabetic foot is impacted by discharge destination
dc.contributor.authorBurmeister, Rebecca A.
dc.contributor.authorJarocki, Christine
dc.contributor.authorHolmes, Crystal M.
dc.contributor.authorRothenberg, Gary M.
dc.contributor.authorMunson, Michael E.
dc.contributor.authorSchmidt, Brian M.
dc.date.accessioned2021-10-05T15:08:01Z
dc.date.available2022-11-05 11:07:57en
dc.date.available2021-10-05T15:08:01Z
dc.date.issued2021-10
dc.identifier.citationBurmeister, Rebecca A.; Jarocki, Christine; Holmes, Crystal M.; Rothenberg, Gary M.; Munson, Michael E.; Schmidt, Brian M. (2021). "Postoperative healing in the diabetic foot is impacted by discharge destination." International Wound Journal 18(5): 657-663.
dc.identifier.issn1742-4801
dc.identifier.issn1742-481X
dc.identifier.urihttps://hdl.handle.net/2027.42/170269
dc.description.abstractThe aim of this study was to evaluate the impact of discharge destination on diabetes‐related limb salvage surgery outcomes post‐hospitalisation. This was a single‐centre, observational, descriptive study of 175 subjects with diabetes who underwent limb salvage surgery of a minor foot amputation or wide incision and debridement for an acutely infected diabetic foot ulcer (DFU). Comparisons were made between subjects discharged home vs a skilled nursing facility (SNF) for 12 months postoperatively. Univariate, multivariate, and time‐to‐event analyses were performed. The SNF discharge group (n = 40) had worse outcomes with longer healing time (P = .022), more rehospitalisations requiring a podiatry consult (P = .009), increase of subsequent ipsilateral major lower‐extremity amputation (P = .028), and a higher mortality rate (P = .012) within the 12‐month postoperative period. There was no significant difference between the cohorts in surgically cleared osteomyelitis (P = .8434). The Charlson Comorbidity Index values for those discharged home and those in a short‐term nursing facility were similar (P = .3819; home x¯=5.33 ± 2.84 vs SNF x¯=5.75 ± 2.06). The planned discharge destination after limb salvage surgery among people with an acutely infected DFU should be an added risk factor for healing outcomes. Patients discharged to SNFs experience additional morbidity and mortality compared with patients discharged home post‐hospitalisation.
dc.publisherBlackwell Publishing Ltd
dc.publisherWiley Periodicals, Inc.
dc.subject.otherlimb salvage
dc.subject.otherminor foot amputation
dc.subject.otherulcer
dc.subject.otherdiabetic foot
dc.subject.otherdischarge planning
dc.subject.otherinfection
dc.titlePostoperative healing in the diabetic foot is impacted by discharge destination
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelMedicine (General)
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/170269/1/iwj13567.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/170269/2/iwj13567_am.pdf
dc.identifier.doi10.1111/iwj.13567
dc.identifier.sourceInternational Wound Journal
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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