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[Screening and management of peripheral arterial obstructive disease in the lower limb wounds amongst diabetic elderly patients]. | LitMetric

[Screening and management of peripheral arterial obstructive disease in the lower limb wounds amongst diabetic elderly patients].

Geriatr Psychol Neuropsychiatr Vieil

Department of Geriatric Medicine, APHP Hôpital Henri Mondor, Creteil, France.

Published: December 2022

AI Article Synopsis

  • The study focuses on diabetic elderly patients (aged 75+) with lower limb wounds, aiming to evaluate the systematic screening and management of peripheral arterial obstructive disease (PAOD) in this population.
  • Out of 501 hospitalized diabetic patients, only 38 were included in the study, showing that a significant portion had bedsores, leg ulcers, or diabetic foot ulcers, with low rates of adequate PAOD screening and treatment.
  • The findings highlight that the management of PAOD is inadequate among these patients, emphasizing the need for better screening practices and education for geriatric doctors to enhance patient care.

Article Abstract

Introduction: Diabetes, a high prevalence chronic disease, especially in the elderly, is a risk factor of chronic lower limb wounds, whose management involves screening and treatment of peripheral arterial obstructive disease (PAOD), which must be systematic. Aim : Evaluate the screening and the management of PAOD amongst those patients, hospitalized in a Geriatric Department.

Methods: Observational, retrospective, monocentric study, including all the elderly above 75 years old, with diabetes, and a wound in the lower limb, hospitalized from 01/01/2018 to 29/02/2020 at Henri Mondor hospital in Créteil.

Results: Over the study period, 2567 patients were hospitalized, including 501 diabetic patients (19,5 %). 38 patients were included. Amongst them, 66 % had a bedsore, 18 % a leg ulcer, and 24 % a diabetic foot ulcer. Concerning the screening of PAOD, 66 % was screened for peripheral pulses, 8 % had an ankle-brachial index, and 45 % at least an imaging including 39 % arterial doppler. Amongst the 21 patients with PAOD, only one had a complete medical treatment, 6 had a revascularization including 5 amputations.

Conclusion: Management of PAOD in the wound of lower limb amongst diabetic elderly patients is insufficient. Although it can be difficult to revascularize them, the screening must be systematic. Educate geriatric doctors in the screening of PAOD and build an expert team amongst them would help to improve that problematic.

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Source
http://dx.doi.org/10.1684/pnv.2022.1067DOI Listing

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