Critical pathway approach to diabetic pedal infections in a multidisciplinary setting

J Foot Ankle Surg. 1999 Jan-Feb;38(1):30-3; discussion 82-3. doi: 10.1016/s1067-2516(99)80085-4.

Abstract

The purpose of this investigation was to evaluate, utilizing clinical and financial outcomes, the critical pathway approach to diabetic foot infections in an inpatient setting. All patients admitted with a primary diagnosis of a diabetic foot infection over an 18-month period from 1995 through 1996 were included in this retrospective study. Comparison is made between the podiatry-established critical pathway and nonpathway patient groups. Then comparison is made between these groups and a similar patient group from 1993 to confirm the validity of the overall results. There was a significant decrease in hospital stay and charges for pathway patients in 1995 and 1996 as compared to nonpathway patients in 1993 as well as 1995 and 1996 (p < .05). The authors also noted a significant decrease in major amputations (BKA or AKA) in pathway patients as compared to baseline values (1993 = 23%, 1995-1996 = 7%, p = .02) and as compared to patients not treated with this approach in 1995 and 1996 (pathway = 7%, nonpathway = 29%, p < .001). The data suggest that the use of a critical pathway approach allows earlier recognition, evaluation, and expedient treatment of potentially limb-threatening infections, improving patient outcomes by decreasing pedal morbidity, while encouraging judicious use of hospital resources.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / statistics & numerical data
  • Costs and Cost Analysis
  • Critical Pathways*
  • Diabetic Foot / complications
  • Diabetic Foot / economics
  • Diabetic Foot / therapy*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Care Team
  • Quality of Health Care
  • Retrospective Studies
  • Rhode Island