Diabetic foot syndrome is a global challenge best managed through multidisciplinary collaboration. This study aimed to investigate the effect of a systematic multidisciplinary team (MDT) on the overall survival and major amputation-free survival of hospitalized patients with diabetic foot infection (DFI). This retrospective cohort study was conducted at Tampere University Hospital. Cohorts of hospitalized patients with DFI before and after the initiation of multidisciplinary wound ward were compared after an 8-year follow-up. Kaplan-Meier analysis revealed significantly higher overall survival in the post-MDT cohort (37.8 % vs 22.6 %, < 0.05) in 8-year follow-up. Similarly, major amputation-free survival was superior in this cohort (31.8 % vs 16.9 %, < 0.05). Additionally, early major amputation was associated with inferior overall survival (35.1 % vs 12.0 %, < 0.05). In a multivariable Cox-regression analysis cohort (hazard ratio [HR] 1.38, 95 % confidence interval [CI95%] 1.01–1.87), early amputation (HR 1.64, CI95% 1.14–2.34) and diagnosed peripheral artery disease (HR 2.23, CI95% 1.61–3.09), congestive heart failure (HR 2.13, CI95% 1.47–3.08), or moderate kidney disease (HR 1.95, CI95% 1.34–2.84) were identified as significant risk factors affecting overall survival. After systematic MDT approach we found improved long-term overall and major amputation-free survival. Multidisciplinary approach is therefore highly recommended for managing patients hospitalized for DFI.

中文翻译：

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糖尿病足感染的多学科治疗与改善 8 年总生存率相关

糖尿病足综合症是一项全球性挑战，最好通过多学科合作来应对。本研究旨在探讨系统性多学科团队（MDT）对糖尿病足感染（DFI）住院患者的总生存期和无大截肢生存期的影响。这项回顾性队列研究是在坦佩雷大学医院进行的。经过 8 年随访后，对进入多学科伤口病房前后的 DFI 住院患者队列进行了比较。 Kaplan-Meier 分析显示，在 8 年随访中，MDT 后队列的总生存率显着更高（37.8% vs 22.6%，< 0.05）。同样，该队列的无大截肢生存率也较高（31.8% vs 16.9%，< 0.05）。此外，早期大截肢与较差的总生存率相关（35.1 % vs 12.0 %，< 0.05）。在多变量 Cox 回归分析队列中（风险比 [HR] 1.38，95% 置信区间 [CI95%] 1.01–1.87），早期截肢（HR 1.64，CI95% 1.14–2.34）和诊断外周动脉疾病（HR 2.23， CI95% 1.61–3.09）、充血性心力衰竭（HR 2.13，CI95% 1.47–3.08）或中度肾脏疾病（HR 1.95，CI95% 1.34–2.84）被确定为影响总生存的重要危险因素。经过系统的 MDT 方法后，我们发现长期总体生存率和无大截肢生存率得到改善。因此，强烈建议采用多学科方法来管理因 DFI 住院的患者。