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Clinical Research
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General Treatment Patterns and Outcomes of Care in 7,622 Patients Treated at 16 Independent Outpatient Wound Centers First Author: Caroline Fife Authors: Gordon Otto, PhD, David Walker, CHT, Brett Thomson, Michael S. Keith, PhD, PharmD, Elizabeth Trevino-Miller Purpose: CMS suggests that analysis of large clinical databases is an alternative to RCTs which exclude many common wounds and co-morbidities. A wound care specific, "Level 4" electronic health record (EHR)* archives all aspects of wound documentation and patient medical care at point of service. Users agree to participate in a "Research Consortium," allowing analysis of "de-identified," longitudinal, unvetted data which is free from possible third party bias. Goals of this study included identification of the "usual wound patient" and their outcomes. Methods: Analysis of data in the EHRs of 16 outpatient wound centers in 11 states was performed, representing 7,622 patients and 81,142 patient visits between 8/31/2001 and 11/24/2006. Average age: 60.4 (1 - 104), with 17% African Americans and 4% Hispanics. Diabetic foot ulcers represented 32.8%, Pressure ulcers 11.7%, venous stasis 11.2%, arterial ulcers 28.0%, and surgical complications 11.7%. Average wound duration at consultation was 210 days. Co-morbid condition prevalence: 32% hypertension, 5.0% renal dialysis, 10.7% smokers, 6.3% CHF. Conclusion: Despite the long duration of wounds at consultation and an average of 6 co-morbid conditions (0-35), the overall healing rate was 74% with 3.7% undergoing amputation (15.2% considered "improved," 2.7% lost to follow up, 4% with no healing). |
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