Socioeconomic Impacts of Diabetic Foot Infection
Name: BIL RANDERSON BASSETTI
Type: MSc dissertation
Publication date: 22/05/2018
Advisor:
Name |
Role |
|---|---|
| RICARDO PINTO SCHUENCK | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| FLAVIA DE PAULA (M/D) | Internal Examiner * |
| RICARDO PINTO SCHUENCK | Advisor * |
Summary: Diabetes mellitus (DM) is a serious, progressive and often neglected disease.
Diabetic foot infection (IPD) is one of the main and most complex complications
observed in patients with DM. The objective of this study was to evaluate the
socioeconomic impacts of the treatment of patients and to describe the
microorganisms that cause diabetic foot infections in a tertiary referral service in the
State of Espírito Santo. It is a retrospective cohort based on the analysis of medical
records for specific procedures (amputations, antimicrobial therapy) and costs for the
components: hospitalization, material and medication, antibiotic therapy, surgical
room and procedures. Quality of life, return to daily and work activities and retirement
were also evaluated. The data were distributed according to the PEDIS classification
(perfusion, extension, deep, infection, sensibility) at the admission of patients to allow
a comparison between those patients classified as PEDIS 2, 3 or 4. Of the 46
patients enrolled in the study, 24 % were classified as PEDIS 2, 39% as PEDIS 3
and 37% as PEDIS 4. An increase of at least six times in the cost of managing
patients classified as 3 (R$ 34,610.66) PEDIS 4 (R$ 48,416.71) in relation to those
classified as PEDIS 2 (R$ 5,361.94). Among the components evaluated, the
expenditures attributed to the "hospitalization" component with the greatest weight,
with 52.2% of the total, followed by operating room (20.3%) and materials and
medicines (13.9%). There is a high rate of amputations already in the first
hospitalization, 56%, with 61% of them minor amputation. Twenty-two patients were
readmitted, most (63%) of them precociously for plastic surgery, however 31%
returned to the hospital to undergo larger amputations. After the surgical treatment,
15% were retired and started to receive benefit from the Government. According to
the own patients' statement, 59% became totally or partially dependent for
performing basic daily activities after amputation. In this way, we can highlight an
increase in the economic and social cost of conducting more severe cases (PEDIS 3
and 4) in relation to those less complexes, such as PEDIS 2.
