与英格兰的外周动脉疾病相关的较大下肢截肢的时间趋势和地理差异
Ravi Maheswaran1, Thaison Tong1, Jonathan Michaels1
1School of Health and Related Research, University of Sheffield, Sheffield, UK.
BJS open
|January 5, 2024
概括
由于外周动脉疾病 (PAD) 造成的下肢主要截肢在男性和糖尿病患者中更高. 上下膝关节截肢 (AKA,BKA) 率和存活率因英国糖尿病状况和地区而异.
科学领域:
- 血管外科 血管外科
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 周围动脉疾病 (PAD) 需要主要的下肢截肢,包括膝盖以上 (AKA) 和膝盖以下 (BKA) 截肢,作为最后的手段.
- 了解截肢率,相关因素和结果对于改善患者护理和资源配置至关重要.
研究的目的:
- 为了调查截肢率,AKA:BKA比率,先前的再血管化,住院时间和截肢后的死亡率.
- 分析英格兰糖尿病患者和没有糖尿病患者这些结果的区域差异.
主要方法:
- 利用基于人口的生态和队列研究设计.
- 分析了从2006年到2018年在31,672个人口普查地区的住院数据.
- 采用Poisson,物流和Cox回归模型进行统计分析.
主要成果:
- 发生了47,249次主要下肢截肢,其中50.7%是AKA;48%的患者患有糖尿病.
- 截肢率在男性中更高,在糖尿病患者中明显更高.
- 膝上截肢 (AKA) 的90天死亡率为25.3%,而膝下截肢 (BKA) 的11.9%.
- 平均存活时间从1.68年 (AKA,糖尿病) 到5.72年 (BKA,没有糖尿病).
- 截肢率,短期死亡率和住院时间随着时间的推移而下降,特别是在糖尿病人群中.
- 在对混因素进行调整后,截肢率,AKA:BKA比率和死亡率的显著区域差异仍然存在.
结论:
- 根据糖尿病状况和截肢水平,主要下肢截肢率和截肢后生存率存在重大差异.
- 截肢结果持续存在的区域差异凸显了针对性干预和公平的医疗保健服务的需要.
相关概念视频
01:11Pulse Assessment Sites
1.1K
Pulse assessment sites are crucial in evaluating a patient's cardiovascular health. By assessing the pulsations of arteries at specific anatomical locations, healthcare professionals can gather valuable information about blood flow, heart rate, and peripheral circulation. Understanding these pulse assessment sites is essential for conducting comprehensive cardiovascular evaluations and monitoring patients' overall health. These sites are strategically chosen due to the accessibility and...
1.1K
01:27Assessment of the Cardiovascular System III: Palpation
342
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
342
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
567
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
567
01:20Arteries of Lower Limbs
1.5K
The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
1.5K