糖尿病足溃疡手术治疗的预测因素。

IF 2.5 3区 医学 Q1 ORTHOPEDICS
Amos Au, Erwin Yii, Ana Andric, Jennifer Wong, Alan Saunder, Ming Yii
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引用次数: 0

摘要

背景与目的:手术在复杂糖尿病足病(DFD)的治疗中起着关键作用。目前,内科治疗与外科治疗的适应症尚不明确。及时发现需要手术治疗的患者可减少发病率和住院时间。本研究旨在分析 DFD 中需要早期手术干预的因素:一项回顾性病例对照研究比较了接受内科治疗的患者和接受外科治疗的患者。研究人员进行了逻辑回归,以确定与糖尿病足并发症手术治疗相关的因素:结果:共纳入 340 名患者。49%的患者需要接受手术治疗。脚趾溃疡、C反应蛋白(CRP)升高和骨髓炎的存在与手术治疗有关。多变量分析计算得出,CRP 的几率比(OR)为 1.01(P 结论):CRP水平升高、前足部糖尿病溃疡和骨髓炎已确诊的患者更有可能接受手术治疗。及时发现这些患者可能有利于更早地做出明确的手术治疗决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of operative management in diabetic foot ulcers.

Background & aims: Surgery plays a key role in the management of complicated diabetic foot disease (DFD). Currently, indications for medical versus surgical management are poorly defined. Prompt identification of patients who require surgery may reduce morbidities and length of hospital stay. This study aims to analyse factors in DFD that necessitate early surgical interventions.

Methods: All patients admitted under a multi-disciplinary diabetic foot team in a tertiary institution over 2 years were included in a retrospective case-control study comparing patients who received medical management and patients who received surgical management. Logistic regression was performed to identify factors associated with surgical management of diabetic foot complications.

Results: Three hundred and forty patients were included. 49% of patients required surgical management. Toe ulceration, elevated C-reactive protein (CRP), and the presence of osteomyelitis were associated with surgical management. Multivariate analysis calculated an odds ratio (OR) of 1.01 for CRP (p < 0.001), OR 2.19 (p < 0.019) favouring surgical management for forefoot ulcers, and OR 2.2 (p < 0.019) if osteomyelitis was present.

Conclusions: Patients with elevated CRP levels, a forefoot diabetic ulcer and established osteomyelitis were more likely to undergo surgical management. Prompt recognition of these patients has the potential benefit of earlier decision making in definitive surgical interventions.

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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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