Assessment, diagnosis and management characteristics of people with acute Charcot neuro-osteoarthropathy in a regional Australian health service: A 3-year retrospective audit

IF 1.9 4区医学 Q2 NURSING

Australian Journal of Rural Health Pub Date : 2024-07-23 DOI:10.1111/ajr.13168

Dimitri Diacogiorgis MApplSc, Byron Matthew Perrin PhD, Michael Ian Charles Kingsley PhD

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引用次数: 0

Abstract

Objective

Acute Charcot neuro-osteoarthropathy (CN) is highly destructive, causing bone and joint damage that can result in devastating structural changes to the foot. The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service.

Design

Three-year retrospective medical record audit.

Setting

Large regional health service with catchment area of >250 000 people in regional Australia.

Participants

People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC).

Main Outcome Measures

Participant characteristics and acute CN assessment, diagnosis and management characteristics. Trends in characteristics were investigated according to rurality as measured by the Modified Monash Model (MMM) scale.

Results

Seventeen participants (20 presentations) of acute CN were identified. Mean age was 57.1 ± 10.8 years, with 11 female participants. Median duration to seek help was 31 (IQR 14–47) days. Total Contact Casting was undertaken for 85% of cases, with those who resided in MMM1-2 regions experienced significantly shorter time to TCC therapy compared to those residing in MMM3-7 regions (U = 3.0, p < 0.01). Resolution of acute CN with or without deformity occurred in 70% of cases.

Conclusions

Those who lived in smaller regional and rural communities were more likely to experience delayed access to gold standard treatment for acute CN. Regional models of care for acute CN should include activities to improve the knowledge of people at risk of acute CN about the condition and upskill regional health professionals for timely and local TCC therapy.

Abstract Image

查看原文本刊更多论文

澳大利亚地区医疗服务机构对急性夏科神经关节病患者的评估、诊断和管理特点：为期三年的回顾性审计。

目的：急性夏科神经骨关节病（CN）具有高度破坏性，会造成骨和关节损伤，从而导致足部结构发生破坏性变化。本研究旨在确定在澳大利亚大型地区医疗服务机构就诊的急性夏科氏神经关节病患者在评估、诊断和管理方面的特点：设计：三年回顾性病历审计：环境：澳大利亚地区的大型区域医疗服务机构，服务范围超过 25 万人：主要结果测量指标：主要结果测量：参与者特征以及急性 CN 评估、诊断和管理特征。根据 "修正莫纳什模型"（MMM）量表测量的农村地区特征对特征趋势进行了调查：共发现 17 名急性 CN 患者（20 例病例）。平均年龄为 57.1 ± 10.8 岁，其中 11 人为女性。求助时间中位数为 31 天（IQR 14-47 天）。居住在较小区域和农村社区的人更有可能延迟获得急性 CN 的金标准治疗。急性氯化萘的区域治疗模式应包括开展各种活动，提高急性氯化萘高危人群对该病的认识，并提高区域卫生专业人员的技能，以便及时在当地进行TCC治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.30

自引率

16.70%

发文量

122

审稿时长

12 months

期刊介绍： The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.