圣彼得堡2010-2021年糖尿病足综合征患者专科护理分析

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM
Diabetes Mellitus Pub Date : 2022-11-30 DOI:10.14341/dm12914
V. Bregovskiy, I. Karpova
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引用次数: 0

摘要

背景:糖尿病足综合征(DFS)所致截肢频率的降低是决定糖尿病患者医疗服务质量的参数之一。目的:我们的目的是研究圣彼得堡2010 - 2021年糖尿病下肢病理患者医疗护理的特征指标。材料和方法:分析2010年至2021年在专门从事DFS手术治疗的城市医院和门诊“糖尿病足”(DFO)的DFS患者治疗的年度报告。结果:每年平均有18,527例患者入住DFO(34,440次就诊)。患有足部溃疡的患者比例为8.9%,而患有夏可氏关节病的患者比例小于1%。在2020年之前,下肢以上截肢的频率从48.3%下降到8.6%,住院死亡率从11.7%下降到5.7%,血管重建术的数量从每年37例增加到642例。手术活动的增加并未伴随着截肢频率的下降(2019年为59.3%)。在所有截肢患者中,11.3%是由DFO转诊的患者。在疫情期间,DFO的访问量和入院患者数量分别下降了27.3%和31%。足部溃疡的比例和截肢的频率没有变化。住院治疗的特点是手术活动减少,血运重建的可用性下降,高度截肢比例增加了两倍,医院死亡率从2019年的5.7%增加到2021年的14.9%。结论:对DFS患者12年的专科护理统计分析显示,高位截肢的频率有所降低,但在截肢在所有手术结构中所占比例几乎不变的背景下,DFS的手术干预频率有所增加。尽管有重要的定量指标,门诊服务在达到目标人群方面似乎不够有效。这一流行病的不利影响导致高截肢率和死亡率显著增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of specialized care for patients with diabetic foot syndrome in St. Petersburg for 2010–2021
BACKGROUND: A decrease in the frequency of amputations due to diabetic foot syndrome (DFS) is one of the parameters that determine the quality of medical care for patients with diabetes mellitus.AIM: Our aim was to study the indicators characterizing medical care for patients with lower limb pathology in diabetes mellitus in St. Petersburg from 2010 to 2021.MATERIALS AND METHODS: Annual reports on the treatment of patients with DFS in city hospitals specializing in the surgical treatment of DFS and in outpatient offices «Diabetic foot» (DFO) from 2010 to 2021 were analyzed.RESULTS: The average number of patients per year admitted to the DFO was 18,527 (34,440 visits). Proportion of patients with foot ulcers — 8,9%, with Charcot’s arthropathy — less than 1%. Before 2020, the frequency of above the foot amputations decreased from 48.3% to 8.6%, hospital mortality — from 11.7 to 5.7%, the number of revascularizations increased from 37 to 642 per year. The increase in operational activity was not accompanied by a decrease in the frequency of amputations (59.3% in 2019). Of all amputations, 11.3% were patients referred from DFO. During the epidemic, the number of visits and patients admitted to the DFO decreased by 27,3% and 31%, respectively. The proportion of foot ulcers and the frequency of amputations have not changed. Inpatient care was characterized by a decrease in operational activity, a decrease in the availability of revascularization, a 2-fold increase in the proportion of high amputations and an increase in hospital mortality from 5.7% in 2019 to 14.9% in 2021.CONCLUSION: An analysis of the statistics of specialized care for patients with DFS over 12 years showed the reduction of the frequency of high amputations, but revealed an increase in the frequency of surgical interventions in DFS against the background of an almost unchanged proportion of amputations in the structure of all operations. Despite significant quantitative indicators, the outpatient service seems to be insufficiently effective in reaching the target population. The negative impact of the epidemic has led to a significant increase in the frequency of high amputations and mortality.
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来源期刊
Diabetes Mellitus
Diabetes Mellitus ENDOCRINOLOGY & METABOLISM-
CiteScore
1.90
自引率
40.00%
发文量
61
审稿时长
7 weeks
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