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dc.contributor.authorSmith-Strøm, Hildeen_US
dc.contributor.authorIversen, Marjolein M.en_US
dc.contributor.authorIgland, Jannickeen_US
dc.contributor.authorØstbye, Trulsen_US
dc.contributor.authorGraue, Mariten_US
dc.contributor.authorSkeie, Sveinen_US
dc.contributor.authorWu, Beien_US
dc.contributor.authorRokne, Beriten_US
dc.date.accessioned2018-04-18T08:33:46Z
dc.date.available2018-04-18T08:33:46Z
dc.date.issued2017-05-12
dc.PublishedSmith-Strøm H, Iversen M.M., Igland J, Østbye T, Graue M, Skeie S, Wu B, Rokne B. Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort study. PLoS ONE. 2017;12(5):e0177176eng
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/1956/17623
dc.description.abstractObjectives: To investigate whether A) duration of ulcer before start of treatment in specialist health care, and B) severity of ulcer according to University of Texas classification system (UT) at start of treatment (baseline), are independent predictors of healing time. Methods: This retrospective cohort study, based on electronic medical record data, included 105 patients from two outpatient clinics in Western Norway with a new diabetic foot ulcer during 2009–2011. The associations of duration of ulcer and ulcer severity with healing time were assessed using cumulative incidence curves and subdistribution hazard ratio estimated using competing risk regression with adjustment for potential confounders. Results: Of the 105 participants, 45.7% achieved ulcer healing, 36.2% underwent amputations, 9.5% died before ulcer healing and 8.5% were lost to follow-up. Patients who were referred to specialist health care by a general practitioner ≥ 52 days after ulcer onset had a 58% (SHR 0.42, CI 0.18–0.98) decreased healing rate compared to patients who were referred earlier, in the adjusted model. High severity (grade 2/3, stage C/D) according to the UT classification system was associated with a decreased healing rate compared to low severity (grade1, stage A/B or grade 2, stage A) with SHR (95% CI) equal to 0.14 (0.05–0.43) after adjustment for referral time and other potential confounders. Conclusion: Early detection and referral by both the patient and general practitioner are crucial for optimal foot ulcer healing. Ulcer grade and severity are also important predictors for healing time, and early screening to assess the severity and initiation of prompt treatment is important.en_US
dc.language.isoengeng
dc.publisherPLOSeng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/17624" target="_blank">Diabetic foot ulcers - predictors of healing time and aspects of telemedicine</a>
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleSeverity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2018-01-11T09:36:05Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2017 The Author(s)
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0177176
dc.identifier.cristin1485911
dc.source.journalPLoS ONE
dc.relation.projectNorges forskningsråd: 221065


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