OBJECTIVE

To evaluate the effectiveness of a multidisciplinary approach to emergency care provision for patients with purulent-septic complications of neuropathic and neuro-ischemic forms of diabetic foot syndrome and lower extremity peripheral artery disease at the Center for Rescue of Extremities of the St. George City Hospital and compare this approach with previously applied one in settings of surgical hospital and lack of specialized vascular care.

MATERIAL AND METHODS

A single-center cohort retrospective study was carried out. Demographic and laboratory data, information on interventions performed for patients with diabetic foot syndrome (DFS) and lower extremity peripheral artery disease (LEPAD) in 2022—2024 were analyzed. The following clinical outcomes were evaluated: mortality, frequency of minor and high amputations, as well as economic outcomes: number of hospitalizations per year, their duration and cost.

RESULTS

Information about 1680 patients has been obtained. Elderly and senile patients with poor control of glycemia and lipid profile predominated. The frequency of performing high amputations in patients with neuro-ischemic form of DFS was 4.66%, with neuropathic — 2.26%, in patients with LEPAD — 3.8%.

None of the evaluated indicators had a statistically significant influence on the probability of high amputation performance. The highest costs were related to the treatment of patients with neuro-ischemic DFS (478 277.75 RUB), the lowest — with neuropathic DFS (112 942.6 RUB).

CONCLUSION

Multidisciplinary approach to the treatment of patients with diabetic foot syndrome and lower extremity peripheral artery disease allowed to reduce the frequency of high amputations. Compliance with continuity between the inpatient and outpatient stages is necessary to ensure timeliness and quality of health care for patients with this pathology, as well as to reduce the costs of its provision.