316. Joint Initiative Between Infectious Diseases and Podiatry in Outpatient Settings Improves Diabetic Foot Infection Patients’ Compliance and Outcomes

Background Many patients with diabetic foot infections (DFI) face challenges with keeping their follow-up appointments. This can result in recurrent DFI. A joint, Infectious Diseases-Podiatry clinic (JIDPC) that an Infectious Diseases (ID) physician and a Podiatrist see their patients together in wound care center once a week was initiated in January 2017. This study was designed to investigate if JIDPC can improve patient compliance and outcomes. Methods A retrospective analysis of the patients admitted to Wheeling Hospital with DFI from March 2013 to December 2017 and required post discharge follow-up by ID and Podiatry was performed. Initially, they were followed by ID and Podiatry in their clinics separately (preintervention group). Beginning January 2017, they were followed together at the JIDPC (postintervention group). Recurrent infection, mortality, and lost to follow-up were compared between the two groups using logistic regression models adjusting for age and sex. Results Among 119 patients, 85 patients were in preintervention group and 34 patients were in postintervention group. Surgeries were performed in 47.1% of preintervention group and 85.3% of postintervention group (P < 0.001) (Table 1). Risk of recurrence in 6 months was significantly higher in preintervention group (odds ratio [OR] = 3.14 [1.07, 9.24]), but with further adjustment for surgery, P-value was 0.05 (OR = 3.08 [0.98–9.62]). Preintervention group was more likely to be lost to follow-up (OR = 3.67 [1.16–11.59]), but the association was attenuated with further adjustment for surgery (OR = 2.17 [0.64–7.41]). Re-admission in 90 days and mortality rate were not significantly different. Conclusion Implementation of JIDPC would be effective to decrease the incidence of recurrent infections among DFI. Table 1: Clinical Characteristics and Comparison Between Pre- and Postintervention Groups Preintervention Group (n = 85) Postintervention Group (n = 34) Characteristic P-Value No. (%) No. (%) Male sex 66 77.7 26 76.5 0.890 Age ≥65 30 35.3 17 50.0 0.138 Osteomyelitis 66 77.7 28 82.4 0.569 Surgery 40 47.1 29 85.3 <.001 Peripheral vascular disease 28 33.0 11 32.4 0.859 Kidney dysfunction 34 40.0 12 35.3 0.634 Poorly controlled diabetes 37 43.5 14 41.2 0.815 Lost follow-up 27 31.8 4 11.8 0.025 Re-admission 27 31.8 12 35.3 0.711 Death 4 4.7 2 5.9 1.000 Recurrent Infection in 6 months 31 36.5 5 16.7 0.044 Disclosures All authors: No reported disclosures.