Impact of pre-hospital delays on the prognosis of older patients with diabetic foot ulcers: a 10-year retrospective study.

IF 1.5 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-04-01 DOI:10.12968/jowc.2023.0284

Hongjuan Zhu, Wanli Chu, Ming Zhang, Sanmai Xiao, Cheng Xu, Zhiyuan Shi

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引用次数: 0

Abstract

Objective: This study aimed to evaluate the impact of pre-hospital delay on the prognosis of older patients with diabetic foot ulcers (DFUs).

Method: In this 10-year retrospective study, enrolled patients were divided into three groups based on the number of days before admission to hospital: <7 days (Group 1); 7-14 days (Group 2); and >14 days (Group 3). Electronic medical data were gathered, including: independent variables (such as age, sex, body mass index, education level and duration of diabetes); and dependent variables (such as number of surgeries, therapeutic regimen, Wagner grade, white blood cell counts, length of hospital stay (LoS), outcomes and treatment costs).

Results: A total of 288 patients were included in the study, 192 of whom were male, and the median age was 65 years. Of the studied participants, 27 arrived at the hospital within seven days, while 223 arrived after >14 days since the onset of their DFU. Significant differences were observed in the distribution of age (p=0.03) among the three groups, with the age of Group 1 lower than that of Group 3 (p=0.02). Significant differences in the distribution of number of surgeries (p=0.01), LoS (p=0.04), outcomes (p=0.04) and costs (p=0.03) were also observed among the three groups. Analyses showed that Group 1 LoS was lower than that of Group 2 (p=0.02); the number of surgeries in Group 1 was lower than that of Group 2 (p<0.01) and Group 3 (p<0.01); and Group 1 costs were lower than those of Group 2 (p=0.03) and Group 3 (p=0.03). A positive relationship was observed between pre-hospital delay and Wagner grade (0.122; p=0.04), and a positive relationship was observed between Wagner grade and LoS (0.181; p<0.01), outcomes (0.294; p<0.01), and costs (0.289; p<0.01).

Conclusion: The findings of this study showed that longer pre-hospital delays adversely affected outcomes, such as extended hospital stays, increased numbers of surgeries and elevated hospitalisation expenses, in patients with DFUs. Age may be an underlying factor for this; further study with an increased sample size and comprehensive data is warranted.

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院前延迟对老年糖尿病足溃疡患者预后的影响：一项10年回顾性研究

目的：探讨院前延误对老年糖尿病足溃疡（DFUs）患者预后的影响。方法：在这项为期10年的回顾性研究中，根据入院前天数将入组患者分为三组：14天（第三组）。收集电子医疗数据，包括：自变量（如年龄、性别、体重指数、教育程度和糖尿病病程）；和因变量（如手术次数、治疗方案、瓦格纳分级、白细胞计数、住院时间（LoS）、结果和治疗费用）。结果：共纳入288例患者，其中男性192例，中位年龄65岁。在研究的参与者中，27人在7天内到达医院，而223人在DFU发病后14天到达医院。三组患者年龄分布差异有统计学意义（p=0.03），其中1组患者年龄低于3组患者（p=0.02）。三组患者在手术次数（p=0.01）、LoS （p=0.04）、结局（p=0.04）、费用（p=0.03）分布上也有显著差异。分析显示，1组的LoS低于2组（p=0.02）；结论：本研究结果表明，较长的院前延误会对DFUs患者的预后产生不利影响，如住院时间延长、手术次数增加和住院费用增加。年龄可能是一个潜在的因素；进一步研究增加样本量和全面的数据是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.