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Frykberg RG, Williams DV, et al.
Journal of the American Podiatric Medical Association. Date of publication 2007 Sep 1;volume 97(5):351-9.
1. J Am Podiatr Med Assoc. 2007 Sep-Oct;97(5):351-9. Negative-pressure wound therapy and diabetic foot amputations: a retrospective study of payer claims data. Frykberg RG(1), Williams DV. Author information: (1)Podiatry Section, Carl T. Hayden Veterans Administration Medical Center, Phoenix, AZ 85012, USA. Comment in J Am Podiatr Med Assoc. 2008 Mar-Apr;98(2):164-5; author reply 165. BACKGROUND: This study was undertaken to assess the benefits of negative-pressure wound therapy (NPWT) versus traditional wound therapies in reducing the incidence of lower-extremity amputations in patients with diabetic foot ulcers. METHODS: Administrative claims data for patients with diabetic foot ulcers from commercial payers (n=3,524) and Medicare (n=12,795) were retrospectively analyzed. Patients were divided into NPWT and control/traditional therapy groups on the basis of administrative codes. Risk-adjustment procedures were then performed to match patient risk categories (through total treatment costs) and wound severities (through debridement depth). RESULTS: The incidence of amputations in the NPWT groups was lower than that in the control groups. For the cost-based risk-adjustment analysis, amputation incidences with NPWT versus traditional therapy were 35% lower in the Medicare sample (10.8% versus 16.6%; P=.0077) and 34% lower in the commercial payer sample (14.1% versus 21.4%; P=.0951). Whereas overall amputation rates increased progressively with increasing wound debridement depth in both control groups, the same increasing trend did not occur in the NPWT groups. CONCLUSIONS: Patients with diabetic foot ulcers in the Medicare sample treated with NPWT had a lower incidence of amputations than those undergoing traditional wound therapy; this finding was evident in wounds of varying depth in both populations studied. PMID: 17901338 [Indexed for MEDLINE]
Appears in following Topics:
Diabetic Foot Ulcer - Treatment