Risk Factors Associated with Amputation-Free Survival in Patient with Diabetic Foot Ulcers
3
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Purpose: To determine the 1-year survival rate, 1-year amputation-free survival rate and the risk factors of amputation for patients with diabetic foot ulcers. Materialsand Methods: One hundred seventy-three patients with diabetic foot ulcers were included in our study. Mean patient age was 67.5 (range, 29 to 87, SD ±11.4) years. 74% of the patients were male. Time from study entry to amputation and time to death were evaluated separately as censored event times by Kaplan-Meier curves and log-rank tests. A multivariate Cox proportional hazards regression analysiswas carried out for determining the risk factors of amputation. Results: The survival rate and amputation-free survival rate were 96.5% (n=167), 65.9% (n=114), respectively, over one year study period. Severity of ulcer was the strongestsignificant risk factor of amputation [hazard ratio (HR): 7.99; confidence interval(CI): 3.12 to 20.47]. Peripheral artery disease was also independent risk factor of amputation (HR: 2.64; CI: 1.52 to 4.59). Conclusion: In assessing the prognosis of diabetic foot ulcers, clinicians should consider the severity of ulcer and presence of peripheral artery disease. Our study provides important insights into clinical practice and supplementary information for both physicians and patients.
Abstract
Purpose: To determine the 1-year survival rate, 1-year amputation-free survival rate and the risk factors of amputation for patients with diabetic foot ulcers. Materialsand Methods: One hundred seventy-three patients with diabetic foot ulcers were included in our study. Mean patient age was 67.5 (range, 29 to 87, SD ±11.4) years. 74% of the patients were male. Time from study entry to amputation and time to death were evaluated separately as censored event times by Kaplan-Meier curves and log-rank tests. A multivariate Cox proportional hazards regression analysiswas carried out for determining the risk factors of amputation. Results: The survival rate and amputation-free survival rate were 96.5% (n=167), 65.9% (n=114), respectively, over one year study period. Severity of ulcer was the strongestsignificant risk factor of amputation [hazard ratio (HR): 7.99; confidence interval(CI): 3.12 to 20.47]. Peripheral artery disease was also independent risk factor of amputation (HR: 2.64; CI: 1.52 to 4.59). Conclusion: In assessing the prognosis of diabetic foot ulcers, clinicians should consider the severity of ulcer and presence of peripheral artery disease. Our study provides important insights into clinical practice and supplementary information for both physicians and patients.
참고문헌 (16)
- Boulton AJ, "The pathway to foot ulceration in diabetes", Med Clin North Am, 97, pp.775~790 (2013)
- Boulton AJ, "The diabetic foot", Khirurgiia (Sofiia), 57, pp.5~8 (2001)
- Stiegler H, "Diabetic foot syndrome", Herz, 29, pp.104~115 (2004)
- Lauterbach S, "Prevalence of diabetic foot syndrome and its risk factors in the UK", J Wound Care, 19, pp.333~337 (2010)
- Pscherer S, "Amputation rate and risk factors in type 2 patients with diabetic foot syndrome under real-life conditions in Germany", Prim Care Diabetes, 6, pp.241~246 (2012)
- Singh N, "Preventing foot ulcers in patients with diabetes", JAMA, 293, pp.217~228 (2005)
- Gregg EW, "Prevalence of lower-extremity disease in the US adult population >=40 years of age with and without diabetes: 1999-2000 national health and nutrition examination survey", Diabetes Care, 27, pp.1591~1597 (2004)
- Winkley K, "Risk factors associated with adverse outcomes in a population-based prospective cohort study of people with their first diabetic foot ulcer", J Diabetes Complications, 21, pp.341~349 (2007)
- Morbach S, "Long-term prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade", Diabetes Care, 35, pp.2021~2027 (2012)
- Abbott CA, "The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort", Diabet Med, 19, pp.377~384 (2002)
- Sun JH, "Risk factors for lower extremity amputation in diabetic foot disease categorized by Wagner classification", Diabetes Res Clin Pract, 95, pp.358~363 (2012)
- Beks PJ, "Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn study", Diabetologia, 38, pp.86~96 (1995)
- Sharp CS, "Microbiology of deep tissue in diabetic gangrene", Diabetes Care, 1, pp.289~292 (1978)
- Wukich DK, "Severity of diabetic foot infection and rate of limb salvage", Foot Ankle Int, 34, pp.351~358 (2013)
- Resnick HE, "Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study", Circulation, 109, pp.733~739 (2004)
- Boyko EJ, "A prospective study of risk factors for diabetic foot ulcer. The Seattle Diabetic Foot Study", Diabetes Care, 22, pp.1036~1042 (1999)