Type of publication:
Conference abstract
Author(s):
*Beard N.B.; *Basavaraju N.B.; *Al-Samaraaie E.A.; *Cane C.C.; *Moulik P.M.
Citation:
Diabetic Medicine. Conference: Diabetes UK Professional Conference 2024. London . 41(Supplement 1) (no pagination), 2024. Date of Publication: 01 Apr 2024.
Abstract:
Background: There is concern that Shropshire and Telford have significantly higher minor and major diabetic foot amputations. Method(s): Data on all 48 major non-traumatic lower limb amputation in diabetes were collected between April 2022 and March 2023. Indicators of care and pathways to amputation were studied. Result(s): 38 (80%) patients were between 50 and 80, 9 (18%) over 80 and 1 (2%) was less than 50 years age. 26 (54%) had below knee and 22 (46%) above knee amputation. 22 (45%) had documented diabetes foot check in the preceding year, 39 (80%) had high risk feet, 28 (58%) previous foot ulcers and 19 (40%) previous minor amputation. 23 (48%) had been seen by the foot protection team in the 8 weeks prior to amputation and 26 (54%) did not have an urgent referral to the muldisciplinary (MDT) foot clinic. 39 (80%) had neuropathy, 38 (80%) had peripheral arterial disease and 10% had Charcot's. SINBAD score was unavailable for 19 (40%) as not seen in MDT clinic, the score was 1, 2, 3, 4, 5 and 6 in 2%, 10%, 8%, 33%, 4% and 2%, respectively, in the rest. Pre-amputation x-rays were available in 54%, antibiotics given in 69%, debridement done in 33% and offloading provided in 60%. 23% had lower limb arterial bypass, 21% had angioplasty and 8% theatre-based debridement. Conclusion(s): Opportunities for improving foot care exist and could prevent or reduce major amputations as majority were in known high risk feet but did not receive NICE recommended care. A significant number of patients were admitted directly for amputation without having the benefit of amputation prevention interventions.
DOI: 10.1111/dme.15296
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