Association between Preventive Podiatric Care and Outcomes of New Diabetic Foot Ulceration among Patients with End Stage Renal Disease @USC @KeckSchool_USC, @USC_Vascular @TzeWoeiTan @APMA @ALPSLIMB @VascularCures @VascularSVS

This was just presented by our team at the American Diabetes Association annual symposium. We’re thrilled that Tze Woei Tan, lead author, was awarded the Marvin Levin Award for top abstract in its category. The study, the first of its kind, evaluated more than 50,000 patients. Those that received podiatric care prior to developing a diabetic foot ulcer were approximately 18% less likely to die or have an amputation over four years of study follow-up.

82nd Scientific Sessions of the ADA

Association between Preventive Podiatric Care and Outcomes of New Diabetic Foot Ulceration among Patients with End Stage Renal Disease

TZE-WOEI TAN;

DAVID G. ARMSTRONG;

CHYI CHYI CHONG;

NICHOLAS J. HAMILTON-COTTER;

ONKAR S. KSHIRSAGAR;

DAVID G. MARRERO;

DENNIS J. COTTER

Objective: To assess the association between foot care by podiatric surgeons and outcomes of new diabetic foot ulceration (DFU) among patients with end-stage renal disease (ESRD) .

Methods: We used the 2015 and 2016 claim data from the United States Renal Data System to identify patients (≥ 40 years and on dialysis for ≥ 12 months) with a new diagnosis of DFU. The patients were stratified into intervention or control cohort based on whether they received any foot care by a podiatric surgeon within 12 months before the diagnosis of a new DFU. Patients were followed from the index DFU date until December 31, 2018. The study outcome was amputation-free survival (composite endpoint of mortality and major amputation) . Adjusted comparisons between preventive foot care and its association with outcomes were performed by Cox-regression analysis after propensity score matching for age, gender, race, hospitalizations, and Charlson Comorbidity Index (CCI) .

Results: Among the 51,362 ESRD patients included, 16,156 (31.5%) received podiatric care within 12 months before their index DFU. Compared to the control cohort, the intervention cohort was older, likely to be female (44% vs. 39%) , and more likely to have peripheral artery disease (64.2% vs. 49.5%) . The overall major amputation rate was 9.6% during study follow-up (intervention: 9.3% vs. control: 9.8%) . A Kaplan-Meier estimate indicated that foot care before index DFU was associated with increased amputation-free survival based on the Log Rank test (p<0.0001) . In addition, the multivariable analysis demonstrated that foot care prior to index DFU was associated with a lower risk of death or major amputation in both the unmatched (Hazard ratio [HR] 0.92, 95% Confidence Interval [CI] 0.90, 0.93, p<0.0001) and matched cohorts (HR 0.82, 95% CI 0.79, 0.85, p<0.0001) .

Conclusion: Among patients with end stage renal disease, preventive podiatric care appears to improve amputation-free survival for DFU.

One thought on “Association between Preventive Podiatric Care and Outcomes of New Diabetic Foot Ulceration among Patients with End Stage Renal Disease @USC @KeckSchool_USC, @USC_Vascular @TzeWoeiTan @APMA @ALPSLIMB @VascularCures @VascularSVS

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  1. I propose to add to the conclusion, the best preventive treatment is the REAT RE CELL that i developpe since 2005 and that,with the antique housse picture there, the Dr Soo-Kyoung Choi in
    (Clearing damaged cells out of the body helps heal diabetics’ blood vessels) tell cllearly the best preventive treatment for all nerves and endothelium and , let say his word( Cleansing nerve ducts, clearing debris will soon be a very promising approach to dealing with autoimmune complications and cancer) is the only one to help to stop foot cuting. I alwedsend this to Dr Armstrong, Dr Fife and the FDA, please, accept to reicieve me for presenting my wonderful discovery

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