糖尿病相关脚和慢性病患者的死亡率和重大截肢
M Beaumont1, K Hobson1, H Rax2
1Department of Vascular Surgery, Te Whatu Ora Te Toka Tumai Auckland, Auckland, New Zealand.
ANZ journal of surgery
|May 31, 2025
概括
与糖尿病相关的足和需要透析的末期病患者的死亡率和主要四肢截肢率显著增加. 这凸显了在为这个脆弱的患者群体规划干预措施时,考虑有限的预期寿命的关键需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 糖尿病学 糖尿病学
- 血管外科 血管外科
背景情况:
- 与糖尿病相关的足部 (DRFU) 是导致发病和死亡的主要原因.
- 功能障碍是DRFU患者常见的并发症,可能会加剧结果.
- 了解功能对DRFU结果的影响对于有效的患者管理至关重要.
研究的目的:
- 调查DRFU管理入院患者的功能状态和结果之间的关联.
- 为了在不同水平的功能中比较死亡率和主要四肢截肢 (MLA) 率.
- 为DRFU功能障碍患者的临床决策和资源分配提供信息.
主要方法:
- 一项对2016年至2021年期间在新西兰阿托亚罗亚 (Aotearoa New Zealand) 住院的DRFU患者的回顾性队列研究.
- 患者被分为三个组:完整的功能,功能障碍和透析需求.
- 卡普兰-梅尔生存分析被用来比较透析和非透析队列之间的死亡率和MLA率.
主要成果:
- 与非透析队列相比,透析队列 (18.7%) 在所有时间点 (1-7年) 上都呈现出明显更高的死亡率 (p < 0.001).
- 在所有测量时间间隔中,透析组的主要肢体截肢 (MLA) 率也明显高于透析组 (p < 0.001).
- 在完整功能患者和功能受损患者 (不包括透析患者) 之间没有观察到结果的显著差异.
结论:
- 患有DRFU和需要透析的末期病的患者经历了显著增加的死亡率和MLA率.
- 这些不良结果甚至在进入DRFU的第一年内就显而易见.
- 透析DRFU患者的临床管理策略必须考虑到他们的预期寿命有限和截肢风险更高.
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