Foot (Edinburgh, Scotland) · 2026
The effectiveness of a one-stop multidisciplinary care service on diabetic foot ulcer healing: A retrospective cohort study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Sirisubjanan Kulika, Koonalinthip Nantawan, Jaroenarpornwatana Araya, Janchai Siriporn
Аннотация
BACKGROUND: Multidisciplinary team care is the standard of care for diabetic foot ulcer (DFU) management, yet traditional models often involve sequential consultations that may delay treatment initiation.
OBJECTIVES: To evaluate whether a one-stop multidisciplinary clinic improves DFU healing outcomes compared with traditional sequential-consultation care.
METHODS: This retrospective cohort study included patients with new-onset DFUs between April 2016 and March 2024. A historical control group (April 2016-March 2020) was compared to an intervention group treated at a one-stop integrated clinic (April 2020-March 2024). The primary outcome was time to complete healing. Secondary outcomes included major lower extremity amputation, and mortality rates. Kaplan-Meier survival analysis and Cox proportional hazards regression models were employed.
RESULTS: Among 237 patients (former clinic, n = 118; integrated clinic, n = 119), the integrated clinic group achieved an overall healing rate of 82%, compared to 71% in the traditional group (p = 0.103). After adjusting baseline characteristics, the integrated clinic was independently associated with faster healing (adjusted hazard ratio = 1.41; 95% CI: 1.04-1.90; p = 0.027). Major amputation and mortality rates remained comparably low across both groups.
CONCLUSIONS: The one-stop multidisciplinary team model significantly improved healing outcomes by providing coordinated, same-day care, effectively overcoming the limitations of sequential referral pathways.
OBJECTIVES: To evaluate whether a one-stop multidisciplinary clinic improves DFU healing outcomes compared with traditional sequential-consultation care.
METHODS: This retrospective cohort study included patients with new-onset DFUs between April 2016 and March 2024. A historical control group (April 2016-March 2020) was compared to an intervention group treated at a one-stop integrated clinic (April 2020-March 2024). The primary outcome was time to complete healing. Secondary outcomes included major lower extremity amputation, and mortality rates. Kaplan-Meier survival analysis and Cox proportional hazards regression models were employed.
RESULTS: Among 237 patients (former clinic, n = 118; integrated clinic, n = 119), the integrated clinic group achieved an overall healing rate of 82%, compared to 71% in the traditional group (p = 0.103). After adjusting baseline characteristics, the integrated clinic was independently associated with faster healing (adjusted hazard ratio = 1.41; 95% CI: 1.04-1.90; p = 0.027). Major amputation and mortality rates remained comparably low across both groups.
CONCLUSIONS: The one-stop multidisciplinary team model significantly improved healing outcomes by providing coordinated, same-day care, effectively overcoming the limitations of sequential referral pathways.