Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia ; School of Medicine, Flinders University, Adelaide, South Australia 5001 Australia.
Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia ; Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032 Australia ; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland 4059 Australia.
J Foot Ankle Res. 2014 Oct 9;7(1):41. doi: 10.1186/s13047-014-0041-x. eCollection 2014.
Australian subacute inpatient rehabilitation facilities face significant challenges from the ageing population and the increasing burden of chronic disease. Foot disease complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute rehabilitation inpatient services, it seems imperative to investigate the prevalence of foot disease and foot disease risk factors in this population. The primary aim of this cross-sectional study was to determine the prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility.
Eligible participants were all adults admitted at least overnight into a large Australian subacute inpatient rehabilitation facility over two different four week periods. Consenting participants underwent a short non-invasive foot examination by a podiatrist utilising the validated Queensland Health High Risk Foot Form to collect data on age, sex, medical co-morbidity history, foot disease risk factor history and clinically diagnosed foot disease complications and foot disease risk factors. Descriptive statistics were used to determine the prevalence of clinically diagnosed foot disease complications, foot disease risk factors and groups of foot disease risk factors. Logistic regression analyses were used to investigate any associations between defined explanatory variables and appropriate foot disease outcome variables.
Overall, 85 (88%) of 97 people admitted to the facility during the study periods consented; mean age 80 (±9) years and 71% were female. The prevalence (95% confidence interval) of participants with active foot disease was 11.8% (6.3 - 20.5), 32.9% (23.9 - 43.5) had multiple foot disease risk factors, and overall, 56.5% (45.9 - 66.5) had at least one foot disease risk factor. A self-reported history of peripheral neuropathy diagnosis was independently associated with having multiple foot disease risk factors (OR 13.504, p = 0.001).
This study highlights the potential significance of the burden of foot disease in subacute inpatient rehabilitation facilities. One in eight subacute inpatients were admitted with active foot disease and one in two with at least one foot disease risk factor in this study. It is recommended that further multi-site studies and management guidelines are required to address the foot disease burden in subacute inpatient rehabilitation facilities.
澳大利亚亚急性住院康复机构面临着人口老龄化和慢性病负担增加带来的重大挑战。足部疾病并发症是许多慢性疾病的负面后果。随着亚急性康复住院服务的快速扩张，似乎有必要调查该人群中足部疾病和足部疾病危险因素的患病率。本横断面研究的主要目的是确定亚急性住院康复机构中活跃的足部疾病和足部疾病危险因素的患病率。
符合条件的参与者均为在两个不同的四周期间至少在一家大型澳大利亚亚急性住院康复机构过夜的成年人。同意的参与者由足病医生进行简短的非侵入性足部检查，使用经过验证的昆士兰健康高风险足部表格收集数据，包括年龄、性别、合并症病史、足部疾病危险因素史以及临床诊断的足部疾病并发症和足部疾病危险因素。使用描述性统计数据确定临床诊断的足部疾病并发症、足部疾病危险因素和足部疾病危险因素组的患病率。逻辑回归分析用于研究定义的解释变量与适当的足部疾病结局变量之间的任何关联。
在研究期间，共有 97 名入住该机构的患者中有 85 名（88%）同意；平均年龄 80（±9）岁，71%为女性。患有活动性足部疾病的参与者的患病率（95%置信区间）为 11.8%（6.3-20.5），32.9%（23.9-43.5）有多种足部疾病危险因素，总体而言，56.5%（45.9-66.5）有至少一个足部疾病危险因素。自我报告的周围神经病诊断史与多种足部疾病危险因素独立相关（OR 13.504，p=0.001）。
本研究强调了亚急性住院康复机构中足部疾病负担的潜在重要性。在这项研究中，每 8 名亚急性住院患者中就有 1 名患有活动性足部疾病，每 2 名患者中就有 1 名患有至少一种足部疾病危险因素。建议需要进一步的多地点研究和管理指南来解决亚急性住院康复机构中的足部疾病负担。
