Breakdown of Diabetic Foot Ulcer Care during the First Year of the Pandemic in Poland: A Retrospective National Cohort Study

The COVID-19 pandemic revealed a breakdown of the system of DFU patient care. This retrospective national cohort study analyses the epidemiological status of DFU patients in relation to urgent and elective hospitalizations, amputation rates, and deaths in Poland from 2017 to 2019, and during 2020 wh...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-03, Vol.19 (7), p.3827
Main Authors: Kleibert, Marcin, Mrozikiewicz-Rakowska, Beata, Bąk, Patrycja Małgorzata, Bałut, Daniel, Zieliński, Jakub, Czupryniak, Leszek
Format: Article
Language:English
Subjects:
Amputation
Ankle
Breakdown
Classification
Cohort analysis
Cohort Studies
Complications
Coronaviruses
COVID-19
COVID-19 - epidemiology
Diabetes
Diabetes Mellitus
Diabetic Foot - epidemiology
Diabetic Foot - therapy
Epidemiology
Fatalities
Foot diseases
Health services
Hospitalization
Hospitals
Humans
Infections
Leg ulcers
Medical records
Mortality
Pandemics
Patients
Poland - epidemiology
Retrospective Studies
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
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Summary:The COVID-19 pandemic revealed a breakdown of the system of DFU patient care. This retrospective national cohort study analyses the epidemiological status of DFU patients in relation to urgent and elective hospitalizations, amputation rates, and deaths in Poland from 2017 to 2019, and during 2020 when the COVID-19 pandemic began. The data were obtained from national medical records gathered by the National Health Fund (NHF). Discharge diagnoses were categorized according to ICD-10 and ICD-9 codes. Analysis of the data showed a statistically significant decrease in elective hospital admissions (from 29.6% to 26.3%, = 0.001). There was a decrease in the percentage of hospitalizations related to limb-salvage procedures (from 79.4% to 71.3%, = 0.001). The opposite tendency was observed among urgent hospital admissions (from 67.0% to 73.2%, = 0.01), which was related to a significant increase in the number of minor amputations (from 3146 to 4269, = 0.017). This rise was in parallel with the increase in the percentage of patients who died during hospitalization due to DFU (from 3.9% to 4.8%, = 0.03). The number of deaths has not changed significantly (from 590.7 to 668.0, = 0.26). The results of the conducted analyses confirm the negative tendencies in the medical care of patients with DFU during the first year of the pandemic in Poland. Changes in therapy schemes and stronger patient support following this period are necessary to avoid further complications in patients with DFU.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19073827