A national, large-scale study co-authored by James Wrobel, MD, DPM, MS, associate professor of Medicine at Rosalind Franklin University of Medicine and Science, found that amputation can be prevented when patients are treated by podiatric physicians.
“More than half of all amputations in the United States are related to diabetes,” Wrobel, director of the Center for Lower Extremity Ambulatory Research at the University’s Dr. William M. Scholl College of Podiatric Medicine, stated in a press release. “Podiatrists are detecting conditions that can lead to amputation. That’s just what we do.”
The first of its kind, the study examined records for almost 29,000 patients with diabetes, ages 18-64 years, and compared health and risk factors for those who had seen podiatrists to those who had not. Researchers found that care by a podiatric physician – defined as at least one visit before a foot ulcer was diagnosed – was associated with a nearly 15% lower risk of amputation and 17% lower risk of hospitalization.
“We statistically matched patients with diabetes and foot ulcers who had visited a podiatrist with like patients who had not,” Teresa Gibson, PhD, lead researcher and director of Health Outcomes Research at Thomson Reuters, stated in the release. “Patients who had seen a podiatrist in the year prior to the onset of a foot ulcer had significantly lower rates of any amputation and hospitalization than those who had not.”
The study was conducted using Thomson Reuters’ MarketScan Research Databases, which contain de-identified health care claims data.
“We found people who looked similar to each other and we were able to observe the outcomes were due to podiatric care rather than something else distorting the data,” Wrobel said. “This is a strong study as it was conducted in patients already having a foot ulcer and it highlights the podiatrist’s role in preventing hospitalizations due to infection and in preventing amputations if a foot ulcer develops.”
Wrobel points to the conclusion of the Thomson Reuters study and numerous smaller studies that preceded it that show expert podiatric care cannot only save limbs but possibly save lives, given that after an amputation the 5-year survival rate is poorer than with many cancers.