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:
