Show simple item record

dc.contributor.authorFincke, Benjamin Gen_US
dc.contributor.authorMiller, Donald Ren_US
dc.contributor.authorTurpin, Robinen_US
dc.date.accessioned2011-12-29T23:07:47Z
dc.date.available2011-12-29T23:07:47Z
dc.date.copyright2010en_US
dc.date.issued2010-7-6en_US
dc.identifier.citationFincke, Benjamin G, Donald R Miller, Robin Turpin. "A classification of diabetic foot infections using ICD-9-CM codes: application to a large computerized medical database." BMC Health Services Research 10:192. (2010)en_US
dc.identifier.issn1472-6963en_US
dc.identifier.urihttp://hdl.handle.net/2144/2634
dc.description.abstractBACKGROUND: Diabetic foot infections are common, serious, and varied. Diagnostic and treatment strategies are correspondingly diverse. It is unclear how patients are managed in actual practice and how outcomes might be improved. Clarification will require study of large numbers of patients, such as are available in medical databases. We have developed and evaluated a system for identifying and classifying diabetic foot infections that can be used for this purpose. METHODS: We used the (VA) Diabetes Epidemiology Cohorts (DEpiC) database to conduct a retrospective observational study of patients with diabetic foot infections. DEpiC contains computerized VA and Medicare patient-level data for patients with diabetes since 1998. We determined which ICD-9-CM codes served to identify patients with different types of diabetic foot infections and ranked them in declining order of severity: Gangrene, Osteomyelitis, Ulcer, Foot cellulitis/abscess, Toe cellulitis/abscess, Paronychia. We evaluated our classification by examining its relationship to patient characteristics, diagnostic procedures, treatments given, and medical outcomes. RESULTS: There were 61,007 patients with foot infections, of which 42,063 were classifiable into one of our predefined groups. The different types of infection were related to expected patient characteristics, diagnostic procedures, treatments, and outcomes. Our severity ranking showed a monotonic relationship to hospital length of stay, amputation rate, transition to long-term care, and mortality. CONCLUSIONS: We have developed a classification system for patients with diabetic foot infections that is expressly designed for use with large, computerized, ICD-9-CM coded administrative medical databases. It provides a framework that can be used to conduct observational studies of large numbers of patients in order to examine treatment variation and patient outcomes, including the effect of new management strategies, implementation of practice guidelines, and quality improvement initiatives.en_US
dc.description.sponsorshipMerck and Companyen_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.rightsCopyright 2010 Fincke et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.titleA Classification of Diabetic Foot Infections Using ICD-9-CM Codes: Application to a Large Computerized Medical Databaseen_US
dc.typearticleen_US
dc.identifier.doi10.1186/1472-6963-10-192en_US
dc.identifier.pubmedid20604921en_US
dc.identifier.pmcid2914721en_US


Files in this item

This item appears in the following Collection(s)

Show simple item record

Copyright 2010 Fincke et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as Copyright 2010 Fincke et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.