Objective: To determine the prevalence of high-risk foot disorders in the adult inpatients of Royal Perth Hospital, a tertiary public hospital in Perth, Western Australia.
Methods: A broad sample of inpatients at Royal Perth Hospital underwent assessment of their feet by Podiatrists and Podiatry Students over the course of one audit day. Data collected included the presence or absence of a foot wound, amputation, deformity, skin and nail disorders, as well as information about previous or current Podiatry review. Demographic data and diagnosis of diabetes were obtained from patient records.
Results: The 293 patients sampled comprised 57% of the hospital inpatients. Of these, 229 (78%) consented to participation and underwent foot assessment. The study population comprised 58% males (median age 67 years) and the prevalence of diabetes was 29%. A foot wound was present in 31 patients (14%), most commonly in the forefoot region and on the plantar surface. Eleven patients (5%) had had an amputation, eight of which were below the ankle (73% minor). Of the 35 patients (15%) with a wound or amputation, 15 (43%) had not had previous or current Podiatry review. Diabetes predicted the presence of a wound or amputation (OR 3.7, 95% CI 1.8-7.8, p=0.001). Amongst the 66 diabetic patients, 12 (18%) had a foot deformity and 21 (32%) had a callosity/corn, ingrown toenail or skin disorder (anhydrosis, maceration, tinea). Of the 38 diabetic patients (58%) with a wound, amputation, or high-risk foot (deformity, skin or nail disorder), 9 (24%) had not had previous or current Podiatry review.
Conclusions: There is a high prevalence of high-risk foot disorders amongst adult tertiary hospital inpatients, especially those with diabetes, and a considerable proportion of these patients have not had previous or current Podiatry review. Improved referral pathways for Podiatry review of inpatients with high-risk foot disorders may improve patient outcomes.