在新诊断的糖尿病足患者中,主要腿部截肢的设施水平变化
Hiroyuki Suzuki1,2,3, Mary Vaughan-Sarrazin2,3, Michael Ohl2,3
1Veterans Rural Health Resource Center-Iowa City, Veterans Affairs (VA) Office of Rural Health, Iowa City, Iowa.
JAMA network open
|April 23, 2025
概括
糖尿病足 (DFU) 护理在医疗机构之间有很大差异,这影响了退伍军人的主要腿截肢率. 退伍军人卫生管理局 (VHA) 必须解决这种变化,以改善DFU患者的治疗结果.
科学领域:
- 医学研究 医学研究
- 医疗服务研究 医疗服务研究
- 糖尿病护理 糖尿病护理
背景情况:
- 糖尿病患病率上升导致糖尿病足 (DFU) 的流行病.
- DFU显著增加了大腿截肢的风险.
- 对于DFU患者的治疗结果在医疗机构的变化,人们知之甚少.
研究的目的:
- 检查与事件DFU退伍军人主要腿部截肢率的设施级别变化.
- 分析医疗保健机构对DFU治疗结果在退伍军人卫生管理局 (VHA) 队列中的影响.
主要方法:
- 在2016-2021年期间,在140个VHA设施中对86,094名被诊断患有DFU的退伍军人进行了回顾性队列研究.
- 在DFU诊断后一年内评估主要腿部截肢率.
- 利用多变量混合效应回归和中位数赔率比 (MOR) 来量化设施级别的变化.
主要成果:
- 总共有3.8%的退伍军人在DFU诊断后一年内进行了大腿截肢.
- 观察到主要腿截肢率的设施级显著变化 (MOR = 1.85,P < .001).
- 一年死亡率的设施水平变化明显较小 (MOR = 1.16,P < .001).
结论:
- 对于糖尿病足患者的VHA设施,主要腿部截肢率存在显著差异.
- 观察到的截肢率变化表明DFU特定的护理质量存在差异.
- VHA应专注于标准化护理,以减少大腿截肢和设施间结果差异.
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