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Audible Bleeding


Dec 4, 2019

December 4, 2019

In our second JVS Meet the Author episode, we also pilot our first Audible Bleeding/JVS Online Journal Club. Jacob Schwartzman joins Dr. Paul DiMuzio from Jefferson and Dr. Sarah Deery from Johns Hopkins in a discussion with first author Dr. Caitlin Hicks. Dr. Hicks is an Assistant Professor of Surgery in the Division of Vascular and Endovascular Therapy at Johns Hopkins in Baltimore, with special interests in health services research and healthcare costs.

On Sunday, December 8th, we will be opening a public Twitter forum/extended online discussion where you can log on to discuss these papers as well as any other literature relevant to the topic. We will be opening several polls on Twitter as well as posting some free-response questions. Questions can be sent to @JVascSurg or searched by #VascularJC.

Dr. Hick’s paper, “Contribution of 30-day readmissions to the increasing costs of care for the diabetic foot,” elucidates some of the very significant healthcare costs related to readmissions for patients with diabetic foot ulcers.

View the transcript of the episode here.

Additional Papers Discussed:

Questions:

  1. For patients with diabetic foot ulcers, Dr. Hicks and colleagues reported a 30-day readmission rate of 20.8%.  What is an expected / acceptable rate of readmission for patients with diabetic foot ulcers?
    • <3%
    • 3-10%
    • 10-15%
    • 15-20%
    • Higher
  2. Dr. Hicks discussed the implementation of a multidisciplinary wound care center which has helped their overall readmission rates drop from 25% in 2013 to just above 10% in 2016. What does your wound care team look like?
  3. In addition to optimizing wound care, what are some other ways that can improve readmission rates?
  4. In her paper, Dr. Hicks discusses that her institution has taken a more aggressive approach to limb salvage and uses toe pressures < 60mmhg as an indication for angiography, even in the presence of palpable pulses.  How does this compare to your practice?
    • I do the same
    • I think this is too aggressive
    • I haven’t done this before but I may do it now
    • I am undecided