RESUMEN
OBJECTIVE: To evaluate the burden of diabetic foot complications amongst inpatients in Peru. MATERIALS AND METHODS: Cross-sectional multicenter study, performed in public hospitals, in one-day enrollment between October and December 2018. RESULTS: We included 8346 patients from 39 national hospitals. Diabetic foot (DF) inpatient point prevalence was 2.8% (CI 95% 2.4-3.1), and DF point prevalence among Diabetes Mellitus (DM) inpatients was 18.9% (CI 95% 16.7-21.1). DF prevalence was higher in jungle and coastal hospitals than highlands ones, and there was no difference according to its care complexity level. Of the 234 patients with DF, 73% were males, age average was 62 ± 12 years, with DM mean time duration of 15 ± 9.9 years. Regarding to DF etiology, 91% and 68% had some degree of peripheral neuropathy and peripheral artery disease, respectively. According to the Infectious Diseases Society of America criteria, 61% presented moderate to severe infections, and 40% had bone involvement. Debridement within 48 h was performed in 36% of sepsis cases. CONCLUSION: Peru has a substantial burden of DF disease, with a greater share of that burden falling on less equipped hospitals in the country's jungle and coastal regions. Interdisciplinary teams and pathways may improve the time of surgical debridement in the highest risk patients.
Asunto(s)
Diabetes Mellitus , Pie Diabético , Anciano , Estudios Transversales , Pie Diabético/diagnóstico , Pie Diabético/epidemiología , Pie Diabético/terapia , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Factores de RiesgoRESUMEN
Objetivo. Describir la frecuencia de las características clínicas y factores asociados a morbilidad intrahospitalaria en pacientes con diabetes mellitus tipo 2 (DM2) en un hospital general, el Hospital Nacional Arzobispo Loayza, entre octubre 2012-abril 2013. Material y Métodos. Estudio observacional longitudinal. Se incluyeron 424 pacientes hospitalizados con diagnóstico de DM2. Se aplicó una ficha de recolección de datos. Los datos fueron extraídos de las historias clínicas y transcritos a una ficha de datos y fueron analizados con el programa Stata. Resultados. La frecuencia de hospitalización por DM2 es 9,62%, el grado de instrucción predominante fue secundaria y superior (52,4%) y 11,3% fueron analfabetos. De los hospitalizados, 11,8% debutaron con la enfermedad; 32,3% no usaron ningún tratamiento hipoglicemiante antes de la hospitalización. La principal causa de hospitalización fueron las infecciones (69,6%); 63% presentaron alguna complicación crónica secundaria a la diabetes. El grupo con mayor estancia hospitalaria fueron pacientes con pie diabético con una media de 21,2 días (4-90). No se encontró asociación entre estancia hospitalaria con glicemia al ingreso y hemoglobina glicosilada. Con una mortalidad 8,96%, la primera causa de muerte fue las infecciones (57,5%).
Objective. To describe the frequency of the clinical features and factors associated with hospital morbidity in patients with type 2 diabetes mellitus (T2DM) at Hospital Nacional Arzobispo Loayza between October 2012-April 2013. Materials and Methods. Longitudinal observational study. We included 424 patients hospitalized with a diagnosis of T2DM. A record of data collection was applied. Data were extracted from medical records and transcribed to a data sheet and analyzed using Stata. Results. The frequency of hospitalization for T2DM of 9,62%, the 11,3% were illiterate, the highest percentages were female 63,2%. The 11,8% of inpatients debuted with the disease, 32,3% did not use any hypoglycemic treatment before hospitalization. The main causes of hospitalization were infection (48,8%). The 63% showed some chronic complications secondary to diabetes. The longer hospital stay groups were patients with diabetic foot with an average of 21,2 days (4-90). No association between hospital stay with glycemia on admission and glycosylated hemoglobin. With 8,96% mortality, the leading cause of death was infections (57,5%).
