Diabetic foot ulcer management in a multidisciplinary foot centre: one-year healing, amputation and mortality rate.
J Wound Care
; 29(8): 464-471, 2020 Aug 02.
Article
em En
| MEDLINE
| ID: mdl-32804035
ABSTRACT
OBJECTIVE:
To describe the rates of healing, major amputation and mortality after 12 months in patients with a new diabetic foot ulcer (DFU) and their care in a French diabetic foot service (DFS).METHOD:
A prospective single-centre study including patients from March 2009 to December 2010. The length of time to healing, minor amputation, major amputation and mortality rate after inclusion were analysed using the Kaplan-Meier method.RESULTS:
Some 347 patients were included (3% lost to follow-up), with a median follow-up (IQR) of 19 (12-24) months. The mean (SD) age was 65±12 years, 68% were male, and the median duration of the ulcer was 49 (19-120) days. Complications of the DFU were ischaemia (70%), infection (55%) and osteomyelitis (47%). Of the patients, 50% were inpatients in the DFS at inclusion (median duration of hospitalisation 26 (15-41) days). The rate of healing at one year was 67% (95% confidence interval (CI) 61-72); of major amputation 10% (95% CI 7-17); of minor amputation 19% (95% CI 14-25), and the death rate was 9% (95% CI 7-13). Using an adjusted hazard ratio, the predictive factors of healing were perfusion and the area of the wound. The risk factors for a major amputation were active smoking and osteomyelitis. The risk factors for mortality were perfusion and age.CONCLUSION:
This study confirms the need to treat DFUs rapidly, in a multidisciplinary DFS.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cicatrização
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Úlcera do Pé
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Pé Diabético
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Amputação Cirúrgica
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article