Observational study of admissions to the inpatient Multidisciplinary Diabetic Foot Unit at Fiona Stanley Hospital: experiences from the first year of operation — ASN Events
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  3. Observational study of admissions to the inpatient Multidisciplinary Diabetic Foot Unit at Fiona Stanley Hospital: experiences from the first year of operation

Observational study of admissions to the inpatient Multidisciplinary Diabetic Foot Unit at Fiona Stanley Hospital: experiences from the first year of operation (#326)

Lydia Lamb 1 , Dipen Sankhesara 1 , Tina Dilevska 2 , Erica Ryan 3 , Ashley Makepeace 4 , P. Gerry Fegan 4 , Carsten Ritter 2 , Paul Norman 2 , Laurens Manning 5 , Emma J Hamilton 4
  1. Department of General Medicine, Fiona Stanley Hospital, Perth, WA, Australia
  2. Department of Vascular Surgery, Fiona Stanley Hospital, Perth, WA, Australia
  3. Podiatry Department, Fiona Stanley Hospital, Perth, WA, Australia
  4. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Murdoch, WA, Australia
  5. Infectious Diseases Department, Fiona Stanley Hospital, Perth, WA, Australia

Background

Foot ulceration is the leading cause of hospitalisation for people with diabetes and diabetes is the most common cause of non-traumatic lower limb amputation.  A multidisciplinary approach to diabetic foot disease reduces amputation rates and improves wound healing.  In February 2015, the first inpatient multidisciplinary diabetic foot unit in Western Australia was opened at Fiona Stanley Hospital (FSH).

Aims

To describe characteristics of patients admitted to the FSH Multidisciplinary Diabetic Foot Unit (MDFU) in the first year of operation.

Methods

We conducted an observational retrospective audit of 155 admissions in 128 patients admitted to the FSH MDFU from 1st February 2015 to January 30th 2016.

Results

The mean (±SD) age of patients admitted to FSH MDFU was 59.3 (±15.5) years.  14.8% of patients had type 1 diabetes, 81.9% had type 2 diabetes; median HbA1c [IQR] was 8.8 [7.2- 10.7] %.  There were twice as many admissions of males than females (67.1% male, 32.9% female).  12.9% admissions occurred in patients of Aboriginal or Torres Strait Islander background.  The most common admission diagnoses were infected diabetic foot ulcer (34.2%), suspected osteomyelitis foot (16.1%), infected diabetic foot ulcer with cellulitis (9.7%) and confirmed osteomyelitis foot (9.0%).  Median creatinine was 94 [73- 143] mmol/L, eGFR 62.1 [38.0- 90.0] mL/min/1.73m2, urine albumin/creatinine ratio 7.7 [2.1- 39.2] mg/mmol and LDL cholesterol 2.0 [1.5- 2.6] mmol/L. 3.9% of admissions resulted in a major amputation and 31.6% of admissions resulted in a minor amputation.  Median length of stay (LoS) for patients admitted to FSH MDFU inpatient unit was 8.5 [6.0-15.0] days. 

Conclusion

The typical patient admitted to FSH MDFU was male with poorly controlled type 2 diabetes, suggesting this may be a key demographic group to target for preventative measures such as foot care education.  Median LoS was relatively short at 8.5 [6.0- 15.0] days.

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