Breakdown of Diabetic Foot Ulcer Care during the First Year of the Pandemic in Poland: A Retrospective National Cohort Study

Marcin Kleibert, Beata Mrozikiewicz-Rakowska, Patrycja Małgorzata Bąk, Daniel Bałut, Jakub Zieliński and Leszek Czupryniak
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Marcin Kleibert: Department of Diabetology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
Beata Mrozikiewicz-Rakowska: Department of Diabetology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
Patrycja Małgorzata Bąk: Department of Diabetology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
Daniel Bałut: Department of Diabetology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
Jakub Zieliński: Interdisciplinary Centre for Mathematical and Computational Modeling, University of Warsaw, 02-106 Warsaw, Poland
Leszek Czupryniak: Department of Diabetology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 7, 1-11

Abstract: The COVID-19 pandemic revealed a breakdown of the system of DFU patient care. This retrospective national cohort study analyses the epidemiological status of DFU patients in relation to urgent and elective hospitalizations, amputation rates, and deaths in Poland from 2017 to 2019, and during 2020 when the COVID-19 pandemic began. The data were obtained from national medical records gathered by the National Health Fund (NHF). Discharge diagnoses were categorized according to ICD-10 and ICD-9 codes. Analysis of the data showed a statistically significant decrease in elective hospital admissions (from 29.6% to 26.3%, p = 0.001). There was a decrease in the percentage of hospitalizations related to limb-salvage procedures (from 79.4% to 71.3%, p = 0.001). The opposite tendency was observed among urgent hospital admissions (from 67.0% to 73.2%, p = 0.01), which was related to a significant increase in the number of minor amputations (from 3146 to 4269, p = 0.017). This rise was in parallel with the increase in the percentage of patients who died during hospitalization due to DFU (from 3.9% to 4.8%, p = 0.03). The number of deaths has not changed significantly (from 590.7 to 668.0, p = 0.26). The results of the conducted analyses confirm the negative tendencies in the medical care of patients with DFU during the first year of the pandemic in Poland. Changes in therapy schemes and stronger patient support following this period are necessary to avoid further complications in patients with DFU.

Keywords: COVID-19; diabetic foot ulcer; SARS-CoV-2; epidemiology; mortality; pandemic; amputation; death; lockdown; healthcare system; public health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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