The experience of an adult diabetic foot unit continuing face-to-face consults during the COVID-19 pandemic

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Internal Medicine Journal Pub Date : 2024-08-31 DOI:10.1111/imj.16514

Joanna Y. Gong, Lucy Collins, Rahul D. Barmanray, Nang S. K. Pang, Minh V. Le, Paul R. Wraight

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Abstract

Background and Aims

The COVID-19 pandemic significantly disrupted lower limb diabetes care. We aimed to map trends in diabetes-related lower limb amputation and hospitalisation rates through the COVID-19 pandemic.

Methods

We performed a retrospective cohort study of all individuals who underwent a lower limb amputation for a diabetes-related foot complication from 2018 to 2021 at the Royal Melbourne Hospital, a quaternary hospital in Australia. Hospitalisation rates with a diabetes-related foot complication were collected for comparison. The start of the COVID-19 epoch was defined as 16 March 2020, when a state of emergency was declared in Melbourne.

Results

During the study period, 360 lower limb amputations for diabetes-related foot complications were performed in 247 individuals. The median monthly number of amputations remained stable prior to and during the COVID-19 epoch; there was a median of 8.0 amputations per month (interquartile range (IQR) = 6.5–11) before COVID-19, compared to 6.5 amputations (IQR = 5.0–8.3) during the COVID-19 epoch (P = 0.23). Hospitalisation with a diabetes-related foot complication significantly increased from a median monthly rate of 11 individuals (IQR = 9.0–14) before COVID-19 to 19 individuals (IQR = 14–22) during the COVID-19 epoch (p < 0.001).

Conclusions

Despite increased hospitalisations for diabetes-related foot complications during COVID-19, there was not a corresponding increase in amputation rates. Face-to-face care of diabetes-related foot complications was prioritised at this centre and may have contributed to stable amputation rates during the pandemic.

Abstract Image

查看原文本刊更多论文

成人糖尿病足科在 COVID-19 大流行期间继续进行面对面会诊的经验。

背景和目的：COVID-19 大流行严重扰乱了下肢糖尿病护理。我们旨在绘制 COVID-19 大流行期间糖尿病相关下肢截肢率和住院率的趋势图：该研究还收集了糖尿病足相关并发症的住院率以进行比较。COVID-19年代的起始时间被定义为2020年3月16日，当时墨尔本宣布进入紧急状态：在研究期间，共有 247 人因糖尿病足并发症而进行了 360 例下肢截肢手术。在COVID-19事件之前和期间，每月截肢次数的中位数保持稳定；在COVID-19事件之前，每月截肢次数的中位数为8.0次（四分位距（IQR）=6.5-11），而在COVID-19事件期间，每月截肢次数的中位数为6.5次（IQR=5.0-8.3）（P=0.23）。与糖尿病相关的足部并发症住院率从 COVID-19 前的每月中位数 11 例（IQR = 9.0-14 例）显著增加到 COVID-19 期间的每月中位数 19 例（IQR = 14-22 例）（P = 0.23）：尽管 COVID-19 期间因糖尿病足并发症住院的人数有所增加，但截肢率并未相应增加。该中心将糖尿病足并发症的面对面治疗作为优先事项，这可能是大流行期间截肢率保持稳定的原因之一。

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

Internal Medicine Journal 医学-医学：内科

CiteScore

3.50

自引率

4.80%

发文量

600

审稿时长

3-6 weeks

期刊介绍： The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.