Taking the next step in 2005, the year of the diabetic foot

Solomon, Stephen B.; Affan, A M; Gopie, Priya; Noël, Jean-Luc; Rahman, R.; Richardson, R.; Ramkisson, Samantha; Mungrue, Kameel; Hasranah, D.; Naraynsingh, Vijay

doi:10.1016/j.pcd.2008.08.004

Cited by 15 publications

(14 citation statements)

References 7 publications

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“…These rates are comparable to those from Sweden, New Zealand study as well as several other regions [19,34,35]. Moreover, the hospital mortality rate of 9% was marginally lower to that published by Solomon et al in a locally conducted study [1]. These rates are higher than the target, which has been set by the Vascular Society and therefore, further highlights that signi cant improvement is necessary.…”

Section: Resultssupporting

confidence: 76%

“…Due to this high degree of variability amongst the population and the absence of a standard assessment tool, the applicability of ndings established internationally cannot be extrapolated to our population [24]. In the Caribbean, there has been several studies which have characterised and placed perspective on major lower limb amputations [1][2][3]. Several reports highlighting the challenges of limb amputations have emerged from countries such as Barbados, Jamaica and Trinidad [2,[25][26][27].…”

Section: Resultsmentioning

confidence: 99%

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A Caribbean perspective: Quality of Life in Major Lower Extremity Amputees

Pran¹,

Baijoo²,

Cave³

et al. 2020

Preprint

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PURPOSE:Lower extremity amputations and diabetic foot-related complications in the Caribbean population have been previously reported [1-3]. However, there is a lack of evidence which assesses the Quality of life experienced in such amputees. The aim of this study was to determine the health-related Quality of life (HRQoL) in patients after a major lower limb amputation.METHODS:All major lower limb amputations undertaken at a tertiary care institution in Trinidad and Tobago, between January 2012 to December 2016 were analysed. The quality of life was assessed using the EURO QOL 5D-5L tool. Statistical analysis was performed using t-test, ANOVA across various subgroups and Kaplan-Meier for mortality. RESULTS:A total of 134 individuals were still alive and willing to participate in the study. The average of HRQoL index value for the cohort was (0.598), which was significantly lower compared to the population norm p < .05 [4]. Statistically significant differences were also seen between patients who ambulated with a prosthesis (.759) compared to those who used another device (0.562), p < 0.05 and to patients who did not ambulate. A comparable Quality of life was seen between the level of amputation (transtibial versus transfemoral) and gender (males versus females), p values were .96 and 1.0 respectively. The overall mortality rate was 14% at 30-days and 27% at one year.CONCLUSION:Overall Quality of life after major amputation, as well as independent mobilisation with a prosthesis, continues to be problematic in the Caribbean population. Factors adversely related to Quality of life post major amputation include increasing age, problems related to mobility and non-ambulatory patients.

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Section: Resultssupporting

confidence: 76%

Section: Resultsmentioning

confidence: 99%

A Caribbean perspective: Quality of Life in Major Lower Extremity Amputees

Pran¹,

Baijoo²,

Cave³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…This is comparable to findings of another study 24 in which 80% of the major amputations were performed on type 2 diabetic patients. This tends to suggest a higher tendency for lower limb amputations in type 2 diabetes.…”

Section: Infra Popliteal Blocksupporting

confidence: 89%

Diabetic Foot- Vasculopathy Assessment and Analysis of Risk Factors of Amputation

Pandurengan¹

2015

Int J Res Med Sci

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“…In an attempt to improve outcomes, the Government of Trinidad and Tobago implemented a “three-tiered approach” to limit the impact of diabetic foot infections: the first tier attempted to prevent foot infections by optimizing metabolic control and promoting healthy lifestyles; 3 – 5 the second tier promoted early detection and prompt treatment of foot infections when they did occur; 6 – 8 and the third tier facilitated research to make local data available for development of evidence-based treatment protocols suited to the local environment. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Adverse events in diabetic foot infections: a case control study comparing early versus delayed medical treatment after home remedies

Cawich

Harnarayan

Islam

et al. 2014

RMHP

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BackgroundThe aim of conventional medical therapy in diabetic foot infections is to control infection, thereby reducing amputation rates, infectious morbidity, and death. Any delay incurred during a trial of home remedies could allow an infection to progress unchecked, increasing the risk of these adverse outcomes. This study sought to determine the effects of delayed operative interventions and amputations in these patients.MethodsA questionnaire study targeting all consecutive patients admitted with diabetic foot infection was carried out over 1 year. Two groups were defined, ie, a medical therapy group comprising patients who sought medical attention after detecting their infection and a home remedy group comprising those who voluntarily chose to delay medical therapy in favor of home remedies. The patients were followed throughout their hospital admissions. We recorded the duration of hospitalization and number of operative debridements and amputations performed.ResultsThere were 695 patients with diabetic foot infections, comprising 382 in the medical therapy group and 313 in the home remedy group. Many were previously hospitalized for foot infections in the medical therapy (78%) and home remedy (74.8%) groups. The trial of home remedies lasted for a mean duration of 8.9 days. The home remedy group had a longer duration of hospitalization (16.3 versus 8.5 days; P<0.001), more operative debridements (99.7% versus 94.5%; P<0.001), and more debridements per patient (2.85 versus 2.45; P<0.001). Additionally, in the home remedy group, there was an estimated increase in expenditure of US $10,821.72 US per patient and a trend toward more major amputations (9.3% versus 5.2%; P=0.073).ConclusionThere are negative outcomes when patients delay conventional medical therapy in favour of home remedies to treat diabetic foot infections. These treatments need not be mutually exclusive. We encourage persons with diabetes who wish to try home remedies to seek medical advice in addition as a part of holistic care.

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Taking the next step in 2005, the year of the diabetic foot

Cited by 15 publications

References 7 publications

A Caribbean perspective: Quality of Life in Major Lower Extremity Amputees

A Caribbean perspective: Quality of Life in Major Lower Extremity Amputees

Diabetic Foot- Vasculopathy Assessment and Analysis of Risk Factors of Amputation

Adverse events in diabetic foot infections: a case control study comparing early versus delayed medical treatment after home remedies

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