Type

Journal Article

Authors

Colin P. Bradley
Ivan J. Perry
Patricia M. Kearney
Graham A Roberts
Fauzi Ali
Claire M. Buckley

Subjects

Medicine & Nursing

Topics
lower extremity self care case control study chronic kidney disease logistic regression analysis risk factors access control healthcare services

Timing of access to secondary healthcare services and lower extremity amputations in patients with diabetes: a case-control study. (2014)

Abstract To investigate the association between timing of patient access to secondary healthcare services for diabetes management and lower extremity amputation (LEA) among patients with diabetes. A case-control study was conducted in the secondary healthcare system in Ireland. Cases were 116 patients with diabetes who underwent a first major non-traumatic LEA between 2006 and 2012. Controls were 348 patients with diabetes, over 45 years, admitted to the same hospital as an emergency or electively, frequency-matched for gender, type of diabetes, and year. Data were collected for 7 years prior to the event year. ORs for LEA in patients with diabetes comparing early versus late referral from primary to secondary healthcare were calculated. Statistically significant risk factors associated with LEA in patients with diabetes included being single, chronic kidney disease, hypertension, and hyperglycemia. Documented retinopathy was a significant protective factor. In unconditional logistic regression analysis adjusted for potential confounders, there was no evidence of a reduced risk of LEA among patients referred earlier to secondary healthcare for diabetes management. Specialist referral may need to occur earlier than the 7-year cut-off used to demonstrate an effect on reducing LEA risk. Documented retinopathy was associated with reduced risk of LEA, most likely as a proxy for better self-care. Variation in the management of diabetes in primary care may also be impacting on outcomes. Efforts to develop more integrated care between primary and secondary services may be beneficial, rather than focusing on timing of referral to secondary healthcare.
Collections Ireland -> University College Cork -> PubMed

Full list of authors on original publication

Colin P. Bradley, Ivan J. Perry, Patricia M. Kearney, Graham A Roberts, Fauzi Ali, Claire M. Buckley

Experts in our system

1
Colin P. Bradley
University College Cork
Total Publications: 62
 
2
Ivan J Perry
University College Cork
Total Publications: 188
 
3
Patricia M. Kearney
University College Cork
Total Publications: 128
 
4
Graham Roberts
University College Cork
Total Publications: 5
 
5
Fauzi Ali
University College Cork
Total Publications: 3
 
6
Claire M. Buckley
University College Cork
Total Publications: 30