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dc.contributor.authorSmith-Strøm, H.
dc.contributor.authorIversen, M. M.
dc.contributor.authorIgland, J.
dc.contributor.authorØstbye, T.
dc.contributor.authorGraue, M.
dc.contributor.authorSkeie, S.
dc.contributor.authorBei, W.
dc.contributor.authorRokne, B.
dc.date.accessioned2021-07-09T10:55:14Z
dc.date.available2021-07-09T10:55:14Z
dc.date.issued2017
dc.identifier.citationSmith-Strøm, H., Iversen, M. M., Igland, J., Østbye, T., Graue, M., Skeie, S., Bei, W. & Rokne, B. (2017). Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort study. PLoS ONE, 12(5), 1–15.en_US
dc.identifier.urihttps://hdl.handle.net/11250/2764033
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.publisherPLoS ONEen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.subjectseverityen_US
dc.subjectdurationen_US
dc.subjectdiabetic foot ulceren_US
dc.subjecttrykksåren_US
dc.subjectpasientsikkerheten_US
dc.titleSeverity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort studyen_US
dc.typeJournal articleen_US
dc.source.pagenumber1–15en_US
dc.source.volume12en_US
dc.source.journalPLoS ONEen_US
dc.source.issue5en_US
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0177176


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