Journal article
Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015-2018)
Journal of wound care, v 30(Sup7), pp S5-S16
01 Jul 2021
PMID: 34256590
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate large propensity-matched cohorts to assess outcomes in patients receiving advanced treatment (AT) with skin substitutes for lower extremity diabetic ulcers (LEDUs) versus no AT (NAT) for the management of LEDUs.
The Medicare Limited Dataset (1 October 2015 through 2 October 2018) were used to retrospectively analyse people receiving care for a LEDU treated with AT or NAT (propensity-matched Group 1). Analysis included major and minor amputations, emergency department (ED) visits and hospital readmissions. In addition, AT following parameters for use (FPFU) was compared with AT not FPFU (propensity-matched Group 2). A paired t-test was used for comparisons of the two groups. For comparisons of three groups, the Kruskal-Wallis test was used. A Bonferroni correction was performed when multiple comparisons were calculated.
There were 9,738,760 patients with a diagnosis of diabetes, of whom 909,813 had a LEDU. In propensity-matched Group 1 (12,676 episodes per cohort), AT patients had statistically fewer minor amputations (p=0.0367), major amputations (p<0.0001), ED visits (p<0.0001), and readmissions (p<0.0001) compared with NAT patients. In propensity-matched Group 2 (1131 episodes per cohort), AT FPFU patients had fewer minor amputations (p=0.002) than those in the AT not FPFU group.
AT for the management of LEDUs was associated with significant reductions in major and minor amputation, ED use, and hospital readmission compared with LEDUs managed with NAT. Clinics should implement AT in accordance with the highlighted parameters for use to improve outcomes and reduce costs.
Metrics
Details
- Title
- Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015-2018)
- Creators
- David G Armstrong - University of Southern CaliforniaWilliam H Tettelbach - Western University of Health SciencesThomas J Chang - St. Cloud Orthopedic AssociatesJulie L De Jong - Mimedx (United States)Paul M Glat - Saint Christopher's Hospital, USJeffrey H Hsu - Kaiser PermanenteMartha R Kelso - Wound Care Strategies (United States)Jeffrey A Niezgoda - AZH Wound & Vascular Centers, USTravis L Tucker - Mimedx (United States)Jonathan M Labovitz - Western University of Health Sciences
- Publication Details
- Journal of wound care, v 30(Sup7), pp S5-S16
- Publisher
- Mark Allen
- Grant note
- R01 DK124789 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000674232800002
- Scopus ID
- 2-s2.0-85110363097
- Other Identifier
- 991021838154104721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Dermatology