{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:30:32Z","timestamp":1793824232142,"version":"4.6.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot infection (DFI), including diabetic foot ulcer, is a serious complication of diabetes, particularly in the South Western Sydney (SWS) region where it is a leading cause of diabetes-related hospitalisations. Multidisciplinary team (MDT) involvement is effective at improving the health outcomes of DFI patients. This study investigated the impact of MDT (High Risk Foot Service, HRFS) on the length of stay and surgical outcomes of inpatients with DFI in a Sydney tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A retrospective audit of electronic medical records of inpatient admissions for DFI at Campbelltown Hospital between January 2019 - December 2021, was performed. The main outcome of the study was MDT involvement, defined as having two or more specialities involved in the patient\u2019s treatment. The other measured variables included length of stay (defined as the total duration from admission to discharge), and surgical outcomes including debridement, minor amputation, and major amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over the three years, 78 participants presented to the hospital for 89 unique DFI admissions. There were 24 admissions in 2019, 28 admissions in 2020, and 37 admissions in 2021, with MDT attendance showing a steady increase at 62.5%, 75.0% and 83.8% respectively. Patients with serious comorbidities such as chronic kidney disease were more likely to have MDT involvement (84.8% vs. 15.2%, P\u2009=\u20090.048). Imaging was more likely to be performed with MDT involvement (78.8% vs. 21.3%, p\u2009&lt;\u20090.05). Comparing patients who received and did not receive MDT care, the mean HbA1c (%) (8.4\u2009\u00b1\u20092.0 vs. 8.2\u2009\u00b1\u20092.7,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.701), median length of stay (LOS: 7.8, IQR 15.0 days vs. 4.8 IQR 7.9 days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.243) and rate of surgical outcomes (74.6% vs. 72.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.262) were similar. Patients who required major amputation had significantly longer LOS (24 days, IQR 21.5 vs. 5.2 days, IQR 13.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) but similar HbA1c (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.552) compared to those who had conservative intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adopting an MDT approach was associated with more thorough investigation of DFI, with similar rates of surgical outcomes. Further research on the impacts of MDT on length of stay and surgical outcomes of DFI patients in other SWS hospitals is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-023-10119-0","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T09:02:58Z","timestamp":1697706178000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of multidisciplinary care of diabetic foot infections for inpatients at Campbelltown Hospital"],"prefix":"10.1186","volume":"23","author":[{"given":"Timothy","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uchechukwu Levi","family":"Osuagwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krupali","family":"Bulsari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Simmons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"issue":"Suppl 1","key":"10119_CR1","doi-asserted-by":"publisher","first-page":"e3280","DOI":"10.1002\/dmrr.3280","volume":"36","author":"BA Lipsky","year":"2020","unstructured":"Lipsky BA, Senneville \u00c9, Abbas ZG, Arag\u00f3n-S\u00e1nchez J, Diggle M, Embil JM, Kono S, Lavery LA, Malone M, van Asten SA, et al. Guidelines on the diagnosis and treatment of foot Infection in persons with Diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36(Suppl 1):e3280.","journal-title":"Diabetes Metab Res Rev"},{"key":"10119_CR2","unstructured":"South West Sydney. Our Health. In. New South Wales, Australia; 2018."},{"key":"10119_CR3","unstructured":"General practice management. of type 2 diabetes \u2013 2014-15. In. Edited by Australia TRACoGPaD. Melbourne: The Royal Australian College of General Practitioners and Diabetes Australia; 2014."},{"key":"10119_CR4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.jcot.2021.01.017","volume":"17","author":"M Edmonds","year":"2021","unstructured":"Edmonds M, Manu C, Vas P. The current burden of diabetic foot Disease. J Clin Orthop Trauma. 2021;17:88\u201393.","journal-title":"J Clin Orthop Trauma"},{"issue":"1","key":"10119_CR5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12902-022-00933-8","volume":"22","author":"UL Osuagwu","year":"2022","unstructured":"Osuagwu UL, Xu M, Piya MK, Agho KE, Simmons D. Factors associated with long intensive care unit (ICU) admission among inpatients with and without Diabetes in South Western Sydney public hospitals using the New South Wales admission patient data collection (2014\u20132017). BMC Endocr Disorders. 2022;22(1):27\u20137.","journal-title":"BMC Endocr Disorders"},{"key":"10119_CR6","unstructured":"Lazzarini PARA, Prentice J, Commons RJ, Fitridge RA, Charles J, Cheney J, Purcell N, Twigg SM. Project obotAD-rFDGP: Australian evidence-based guidelines for diabetes-related foot disease. 2021, version 1.0."},{"issue":"4","key":"10119_CR7","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.endinu.2017.02.009","volume":"64","author":"S Jim\u00e9nez","year":"2017","unstructured":"Jim\u00e9nez S, Rubio JA, \u00c1lvarez J, Ruiz-Grande F, Medina C. Trends in the incidence of lower limb amputation after implementation of a Multidisciplinary Diabetic Foot Unit. Endocrinolog\u00eda Diabetes Y nutrici\u00f3n. 2017;64(4):188\u201397.","journal-title":"Endocrinolog\u00eda Diabetes Y nutrici\u00f3n"},{"issue":"6","key":"10119_CR8","doi-asserted-by":"publisher","first-page":"324","DOI":"10.12968\/jowc.2017.26.6.324","volume":"26","author":"A Buggy","year":"2017","unstructured":"Buggy A, Moore Z. The impact of the multidisciplinary team in the management of individuals with diabetic foot ulcers: a systematic review. J Wound Care. 2017;26(6):324\u201339.","journal-title":"J Wound Care"},{"key":"10119_CR9","doi-asserted-by":"publisher","first-page":"107996","DOI":"10.1016\/j.diabres.2019.107996","volume":"161","author":"RH Albright","year":"2020","unstructured":"Albright RH, Manohar NB, Murillo JF, Kengne LAM, Delgado-Hurtado JJ, Diamond ML, Acciani AL, Fleischer AE. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with Diabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract. 2020;161:107996\u20136.","journal-title":"Diabetes Res Clin Pract"},{"issue":"62","key":"10119_CR10","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s13047-015-0120-7","volume":"8","author":"D Plusch","year":"2015","unstructured":"Plusch D, Penkala S, Dickson HG, Malone M. Primary care referral to multidisciplinary high risk foot services - too few, too late. J Foot Ankle Res. 2015;8(62):62\u20132.","journal-title":"J Foot Ankle Res"},{"issue":"4","key":"10119_CR11","doi-asserted-by":"publisher","first-page":"e0124739","DOI":"10.1371\/journal.pone.0124739","volume":"10","author":"F Chuan","year":"2015","unstructured":"Chuan F, Tang K, Jiang P, Zhou B, He X. Reliability and validity of the perfusion, extent, depth, Infection and sensation (PEDIS) classification system and score in patients with Diabetic Foot Ulcer. PLoS ONE. 2015;10(4):e0124739.","journal-title":"PLoS ONE"},{"issue":"1","key":"10119_CR12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13047-021-00471-x","volume":"14","author":"UG Vo","year":"2021","unstructured":"Vo UG, Gilfillan M, Hamilton EJ, Manning L, Munshi B, Hiew J, Norman PE, Ritter JC. Availability and service provision of multidisciplinary Diabetes foot units in Australia: a cross-sectional survey. J Foot Ankle Res. 2021;14(1):27.","journal-title":"J Foot Ankle Res"},{"issue":"4","key":"10119_CR13","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1016\/j.jvs.2019.08.244","volume":"71","author":"M Jackson","year":"2020","unstructured":"Jackson M, Bryn LS, Suleyman K, Prakash B, Christie MB, Meghan BB. A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg. 2020;71(4):1433\u20131446e1433.","journal-title":"J Vasc Surg"},{"key":"10119_CR14","doi-asserted-by":"crossref","unstructured":"Ahmed MU, Tannous WK, Agho KE, Henshaw F, Turner D, Simmons D. Prevalence and burden of diabetes-related Foot Disease in New South Wales, Australia: evidence from the 45 and up Study Survey Data Linked with Health Services Data. Int J Environ Res Public Health 2021, 18(21).","DOI":"10.3390\/ijerph182111528"},{"issue":"1","key":"10119_CR15","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13047-022-00545-4","volume":"15","author":"RJ Commons","year":"2022","unstructured":"Commons RJ, Charles J, Cheney J, Lynar SA, Malone M, Raby E, on behalf of the Australian Diabetes-related Foot, Disease G, Pathways P. Australian guideline on management of diabetes-related foot Infection: part of the 2021 Australian evidence-based guidelines for diabetes-related foot Disease. J Foot Ankle Res. 2022;15(1):47.","journal-title":"J Foot Ankle Res"},{"issue":"4","key":"10119_CR16","doi-asserted-by":"publisher","first-page":"308","DOI":"10.4093\/dmj.2017.0076","volume":"42","author":"CH Kim","year":"2018","unstructured":"Kim CH, Moon JS, Chung SM, Kong EJ, Park CH, Yoon WS, Kim TG, Kim W, Yoon JS, Won KC, et al. The changes of trends in the diagnosis and treatment of Diabetic Foot Ulcer over a 10-Year period: single Center Study. Diabetes Metab J. 2018;42(4):308\u201319.","journal-title":"Diabetes Metab J"},{"issue":"2","key":"10119_CR17","first-page":"82","volume":"30","author":"SM Manewell","year":"2022","unstructured":"Manewell SM, Aitken SJ, Nube VL, Crawford AM, Constantino MI, Twigg SM, Menz HB, Sherrington C, Paul SS. Length of stay and readmissions for people with diabetes-related foot ulceration admitted to two public tertiary referral hospitals in Australia. Wound Pract Research: J Australian Wound Manage Association. 2022;30(2):82\u201390.","journal-title":"Wound Pract Research: J Australian Wound Manage Association"},{"issue":"4","key":"10119_CR18","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1001\/jama.288.4.475","volume":"288","author":"D Schillinger","year":"2002","unstructured":"Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of Health Literacy with Diabetes Outcomes. JAMA. 2002;288(4):475\u201382.","journal-title":"JAMA"},{"issue":"17","key":"10119_CR19","doi-asserted-by":"publisher","first-page":"3977","DOI":"10.3390\/jcm10173977","volume":"10","author":"M Meloni","year":"2021","unstructured":"Meloni M, Morosetti D, Giurato L, Stefanini M, Loreni G, Doddi M, Panunzi A, Bellia A, Gandini R, Brocco E, et al. Foot Revascularization avoids major amputation in persons with Diabetes and ischaemic foot ulcers. J Clin Med. 2021;10(17):3977.","journal-title":"J Clin Med"},{"issue":"6","key":"10119_CR20","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1111\/ans.18224","volume":"93","author":"SM Manewell","year":"2023","unstructured":"Manewell SM, Aitken SJ, Nube VL, Crawford AM, Constantino MI, Twigg SM, Menz HB, Sherrington C, Paul SS. Timing of minor and major amputation in patients with diabetes-related foot ulceration admitted to two public tertiary referral hospitals in Australia. ANZ J Surg. 2023;93(6):1510\u20136.","journal-title":"ANZ J Surg"},{"issue":"6","key":"10119_CR21","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1053\/j.jfas.2006.09.015","volume":"45","author":"JS Wrobel","year":"2006","unstructured":"Wrobel JS, Robbins J, Armstrong DG. The high-low amputation ratio: a deeper insight into Diabetic Foot Care? J foot Ankle Surg. 2006;45(6):375\u20139.","journal-title":"J foot Ankle Surg"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-023-10119-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-023-10119-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-023-10119-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,19]],"date-time":"2023-11-19T21:17:48Z","timestamp":1700428668000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-023-10119-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,19]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["10119"],"URL":"https:\/\/doi.org\/10.1186\/s12913-023-10119-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2800243\/v1","asserted-by":"object"}]},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,19]]},"assertion":[{"value":"11 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was the study is approved by the \u201cSouth Western Sydney Local Health District Human Research\u201d ethics committee (#QA18\/021). The study was conducted in accordance with the Declaration of Helsinki. Informed consent was waived by the same ethics committee that approved the study (South Western Sydney Local Health District Human Research ethics committee).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1126"}}