Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Chiropody Team, Unity Health Toronto-St. Michael's Hospital, Toronto, Ontario, Canada.
Int Wound J. 2023 Oct;20(8):3331-3337. doi: 10.1111/iwj.14214. Epub 2023 May 7.
This manuscript describes the implementation and initial evaluation of a novel Canadian acute care pathway for people with a diabetic foot ulcer (DFU). A multidisciplinary team developed and implemented an acute care pathway for patients with a DFU who presented to the emergency department (ED) and required hospitalisation at a tertiary care hospital in Canada. Processes of care, length of stay (LOS), and hospitalisation costs were considered through retrospective cohort study of all DFU hospitalizations from pathway launch in December 2018 to December 2020. There were 82 DFU-related hospital admissions through the ED of which 55 required invasive intervention: 28 (34.1%) minor amputations, 16 (19.5%) abscess drainage and debridement, 6 (7.3%) lower extremity revascularisations, 5 (6.1%) major amputations. Mean hospital LOS was 8.8 ± 4.9 days. Mean hospitalisation cost was $20 569 (±14 143): $25 901 (±15 965) when surgical intervention was required and $9279 (±7106) when it was not. LOS and hospitalisation costs compared favourably to historical data. An acute care DFU pathway can support the efficient evaluation and management of patients hospitalised with a DFU. A dedicated multidisciplinary DFU care team is a valuable resource for hospitals in Canada.
本文档描述了一种新型加拿大急性护理路径在糖尿病足溃疡（DFU）患者中的实施和初步评估。一个多学科团队为在加拿大一家三级护理医院因糖尿病足溃疡就诊并需要住院的患者制定并实施了急性护理路径。通过对 2018 年 12 月至 2020 年 12 月路径启动后所有糖尿病足溃疡住院患者的回顾性队列研究，考虑了护理流程、住院时间（LOS）和住院费用。有 82 例与糖尿病足溃疡相关的患者通过急诊科入院，其中 55 例需要侵入性干预：28 例（34.1%）小截肢，16 例（19.5%）脓肿引流和清创术，6 例（7.3%）下肢血管重建术，5 例（6.1%）大截肢术。平均住院 LOS 为 8.8±4.9 天。平均住院费用为 20569 美元（±14143 美元）：需要手术干预时为 25901 美元（±15965 美元），不需要手术干预时为 9279 美元（±7106 美元）。LOS 和住院费用与历史数据相比具有优势。急性护理 DFU 路径可以支持对因 DFU 住院的患者进行有效的评估和管理。专门的多学科 DFU 护理团队是加拿大医院的宝贵资源。
