RESUMO
BACKGROUND: Diabetic foot is a complex syndrome that is associated with other diabetic complications, such as peripheral arte-rial disease and peripheral neuropathy. Optimization of plasma glucose and glycated hemoglobin (HbA1c) is one of the main principles of standard care and treatment approaches in individuals with diabetes mellitus (DM). In this study, the relationship of HbA1c level at the time of diagnosis was evaluated with diabetic foot disease severity score and surgical extension in patients with Type 2 DM. METHODS: This study included 301 consecutive patients who were diagnosed with diabetic foot in the general surgery diabetic foot clinic and were hospitalized for surgery. The relationships between the HbA1c levels of the patients with the Wagner and PEDIS (Perfusion, Extent, Dept, Infection, Sensation) classification system grades, and the surgical procedures performed were analyzed and the treatment outcomes were evaluated. RESULTS: It was determined that there was a 90% statistically significant relationship between HbA1c values of ≥10.1% and the de-velopment of Wagner Grade 4 diabetic foot ulcer (DFU) (P=0.037). A strong statistically significant relationship at the rate of 85% was determined between HbA1c values of ≥10.1% and the development of PEDIS Grade 3 ulcers. As the HbA1c values increased, so there was determined to be a statistically significant relationship with the development of PEDIS Grade 3 ulcer (P=0.003). In the comparison of the HbA1c values according to the type of surgery performed, a weak relationship was determined at the rate of 26%, and it was determined that as the HbA1c values increased, so there could be an increase in the amputation level. CONCLUSION: The results of this study showed that as HbA1c values at diagnosis increased in patients with diabetic foot; Wagner/PEDIS grades, disease severity, surgical extension, amputation level, and tissue loss increased. To reduce the severity of diabetic foot disease and prevent amputation, compliance with diabetic treatment and glycemic control should be increased.
Assuntos
Diabetes Mellitus , Pé Diabético , Humanos , Pé Diabético/complicações , Pé Diabético/cirurgia , Hemoglobinas Glicadas , Gravidade do Paciente , Amputação Cirúrgica , Cooperação do PacienteRESUMO
BACKGROUND: Long-term bowel dysfunction after resection for rectal cancer, known as low anterior resection syndrome (LARS), is observed in many patients. The LARS score was developed to assess this syndrome and its impact on the quality of life in Danish patients. Recently versions in English and many other languages have been validated. The aim of this study was to validate the Turkish translation of the LARS score in patients who have undergone treatment for rectal cancer. METHODS: Rectal cancer patients who underwent low anterior resection in May 2000- May 2018 in three Turkish centers received the LARS score questionnaire, the European Organisation for Research and Treatment Of Cancer Core Quality of Life questionnaire [Ed.11] (EORTC QLQ-C30), and a single ad hoc quality of life question. The test-retest reliability of the LARS score was evaluated by asking a randomly selected subgroup of patients to repeat the assessment of the LARS score 2 to 4 weeks after their initial response. RESULTS: A total of 326 patients were reviewed and contacted for the study, and 222 (68%) were eligible for the analyses (129 males, 93 females, median age 64 years [range:24-87 years, IQR = 14]) There was a strong association between the LARS score and quality of life (p < 0.01) and the test-retest reliability was high. The intraclass correlation coefficient was 0.78 (95% CI 0.73-0.83) for the whole study group and 0.79 (95% CI 0.68-0.87) for the subgroup, indicating strong reliability. CONCLUSIONS: The Turkish translation of the LARS score has psychometric properties comparable with previously published results in similar studies. The Turkish version of the LARS score can be considered a valid and reliable tool for measuring LARS in Turkish rectal cancer patients. CLINICAL TRIAL REGISTRATION: NCT05289531.