糖尿病足发病前的健行状态作为截肢和1年结果的预测因素:回顾性分析
Devin J Clegg1, Jordan G Tasman2, Erica N Whiteaker3
1From the Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tenn.
Plastic and reconstructive surgery. Global open
|November 13, 2023
概括
患有糖尿病足的非行走 (NA) 或带有辅助设备的行走 (AWAD) 患者在一年内面临更高的截肢和死亡风险. 评估移动状态对于糖尿病肢体的挽救至关重要.
科学领域:
- 糖尿病的肢体救援
- 足科研究 足科研究
- 糖尿病并发症 糖尿病并发症
背景情况:
- 糖尿病足 (DFU) 在85%的非创伤性下肢截肢之前发生.
- 糖尿病患者的大型截肢与高5年死亡率 (52%-80%) 有关.
- 有限的研究存在于诊断前的门诊状态对DFU结果的预测价值.
研究的目的:
- 调查是否诊断前的门诊状态预测糖尿病足患者的截肢和1年的结果.
- 确定运动限制与重大截肢风险之间的关系.
- 评估门诊状态对DFU诊断后死亡率和再入院率的影响.
主要方法:
- 在2011年至2021年期间,对506名被诊断为DFU的II型糖尿病患者进行了回顾性评估.
- 门诊状态的分类:独立,带辅助设备的门诊 (AWAD) 或非门诊 (NA).
- 使用千平方,多项和多变量逻辑回归的统计分析.
主要成果:
- 非行走 (NA) 和AWAD状态是住院期间重大截肢的重要预测因素 (OR=5.10,P=0.002为NA;OR=2.77,P=0.01为AWAD).
- 无论是NA还是AWAD状态都预测了30天急诊室访问和1年死亡率的风险增加.
- AWAD状态也与更高的30天再入院率和1年内任何截肢率有关.
结论:
- 在糖尿病足患者中,诊断前的非行走 (NA) 和带有辅助设备的行走 (AWAD) 状态是重大截肢和较差的一年结果 (包括死亡率) 的强有力的预测因素.
- 门诊状态评估是为DFU管理中的治疗策略提供信息的宝贵工具.
- 早期识别运动限制可以有助于风险分层和肢体救援工作.
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