[Recurrence and influencing factors of diabetic foot ulcer in patients with type 2 diabetes mellitus]
- PMID: 33105947
- DOI: 10.3760/cma.j.cn501120-20190726-00315
[Recurrence and influencing factors of diabetic foot ulcer in patients with type 2 diabetes mellitus]
Abstract
Objective: To investigate the recurrence and influencing factors of diabetic foot ulcer in patients with type 2 diabetes mellitus. Methods: Totally 185 type 2 diabetes patients with new-onset of diabetic foot ulcers admitted to Fuyang People's Hospital of Anhui Province from January 2011 to December 2015 were enrolled in this study, including 120 males and 65 females, aged 40-79 years. All the patients were followed up for 3 years, and their clinical data were retrospectively analyzed by the case-control study. The Kaplan-Meier cumulative recurrence curve was drawn according to the 3-year cumulative recurrence rate of diabetic foot ulcers. The time to visit, toe involvement, and amputation of involved toes in patients with recurrent diabetic foot ulcer were counted at the initial onset and the recurrence of the ulcers, respectively, and the data were statistically analyzed with t test and chi-square test. According to the recurrence of diabetic foot ulcers, the patients were divided into foot ulcer recurrence group and foot ulcer non-recurrence group. The gender, age, course of diabetes mellitus, length of hospital stay, visit time, body mass index, glycosylated hemoglobin HbA1c, total bilirubin, albumin, creatinine, cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, hemoglobin, white blood cell count, toe involvement, toe amputation, ankle-brachial index, diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN), diabetic nephropathy (DN), history of hypertension, cardio-cerebrovascular disease, smoking, residence, solitary life, and walking disorder of patients between the two groups were compared, and the data were statistically analyzed with t test and chi-square test. Log-rank test was performed on the indexes with P<0.1 in comparison between two groups, and the indexes with statistically significant differences in Log-rank test were analyzed by multivariate Cox regression analysis to screen the influencing factors of recurrence of diabetic foot ulcer. Results: (1) The 3-year cumulative recurrence rate of diabetic foot ulcers in 185 patients with type 2 diabetes mellitus was 47.0% (87/185). (2) For 87 patients with diabetic foot ulcer recurrence, compared with that at the initial onset of the ulcers, the visit time was significantly shorter (t=10.593, P<0.01), the toe amputation rate was significantly increased (χ(2)=5.118, P<0.05), but there was no obvious change in toe involvement at the recurrence of the ulcers. (3) There were statistically significant differences in age, course of diabetes mellitus, length of hospital stay, body mass index, glycosylated hemoglobin HbA1c, total bilirubin, albumin, creatinine, cholesterol, LDL, HDL, hemoglobin, white blood cell count, gender, toe amputation, ankle-brachial index, DR, history of cardio-cerebrovascular disease, solitary life, and walking disorder of patients between foot ulcer recurrence group (87 patients) and foot ulcer non-recurrence group (98 patients) (t=5.123, 4.242, 5.324, -24.572, 6.102, -1.984, -9.747, 3.226, 3.076, 3.646, -4.683, -7.502, 8.095, χ(2)=5.621, 18.433, 4.546, 5.785, 9.655, 7.625, 7.886, P<0.05 or P<0.01), while the rest of the indexes of patients between the two groups were similar. Log-rank test showed that the two groups had statistically significant differences in age, course of diabetes mellitus, length of hospital stay, glycosylated hemoglobin HbA1c, total bilirubin, albumin, creatinine, ankle-brachial index, DPN, and walking disorder (χ(2)=210.046, 44.837, 34.107, 98.685, 66.532, 294.451, 260.554, 5.012, 6.818, 11.160, P<0.05 or P<0.01). Age, total bilirubin, albumin, DPN, and walking disorder were the influencing factors for the recurrence of diabetic foot ulcers in patients with type 2 diabetes mellitus (hazard ratio=1.024, 0.678, 0.849, 2.335, 4.099, 95% confidence interval=1.001-1.047, 0.558-0.823, 0.797-0.904, 1.280-4.258, 2.044-8.223, P<0.05 or P<0.01). Conclusions: The 3-year cumulative recurrence rate of diabetic foot ulcers in patients with type 2 diabetes mellitus is relatively high, with the influencing factors being age, total bilirubin, albumin, DPN, and walking disorder.
目的: 探讨2型糖尿病患者糖尿病足溃疡复发情况及影响因素。 方法: 2011年1月—2015年12月,安徽省阜阳市人民医院收治符合入选标准的初发糖尿病足溃疡的2型糖尿病患者185例,其中男120例、女65例,年龄40~79岁,均随访3年,以病例对照研究的方法对其临床资料进行回顾性分析。统计糖尿病足溃疡3年累计复发率,绘制Kaplan-Meier累计复发曲线。统计糖尿病足溃疡复发患者初发和复发溃疡时的就诊时间、足趾受累和受累足趾截趾情况,对数据行t检验、χ(2)检验。根据糖尿病足溃疡复发情况,将患者分为足溃疡复发组和足溃疡未复发组,比较2组患者性别、年龄、糖尿病病程、住院时间、就诊时间、体质量指数、糖化血红蛋白HbA1c、总胆红素、白蛋白、肌酐、胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯、血红蛋白、白细胞计数、足趾受累、截趾、踝肱指数、糖尿病视网膜病变(DR)、糖尿病周围神经病变(DPN)、糖尿病肾病(DN)、高血压病史、心脑血管病史、吸烟史、居住地、独居和行走障碍情况,对数据行t检验、χ(2)检验;选取2组比较P<0.1的指标行Log-rank检验,对检验结果有统计学意义的指标行多因素Cox回归分析,筛选糖尿病足溃疡复发的影响因素。 结果: (1)185例2型糖尿病患者的糖尿病足溃疡3年累计复发率为47.0%(87/185)。(2)与初发时比较,87例糖尿病足溃疡复发患者复发溃疡时的就诊时间明显缩短(t=10.593,P<0.01),截趾率明显升高(χ(2)=5.118,P<0.05),足趾受累无明显变化。(3)87例足溃疡复发组患者与98例足溃疡未复发组患者在年龄、糖尿病病程、住院时间、体质量指数、糖化血红蛋白HbA1c、总胆红素、白蛋白、肌酐、胆固醇、LDL、HDL、血红蛋白、白细胞计数及性别、截趾、踝肱指数、DR、心脑血管病史、独居和行走障碍方面比较,差异有统计学意义(t=5.123、4.242、5.324、-24.572、6.102、-1.984、-9.747、3.226、3.076、3.646、-4.683、-7.502、8.095,χ(2)=5.621、18.433、4.546、5.785、9.655、7.625、7.886,P<0.05或P<0.01);2组患者其余指标相近。Log-rank检验显示,2组患者在年龄、糖尿病病程、住院时间、糖化血红蛋白HbA1c、总胆红素、白蛋白、肌酐、踝肱指数、DPN、行走障碍方面比较,差异有统计学意义(χ(2)=210.046、44.837、34.107、98.685、66.532、294.451、260.554、5.012、6.818、11.160,P<0.05或P<0.01)。年龄、总胆红素、白蛋白、DPN及行走障碍是2型糖尿病患者糖尿病足溃疡复发的影响因素(风险比=1.024、0.678、0.849、2.335、4.099,95%置信区间=1.001~1.047、0.558~0.823、0.797~0.904、1.280~4.258、2.044~8.223,P<0.05或P<0.01)。 结论: 2型糖尿病患者糖尿病足溃疡3年累计复发率较高,其影响因素为年龄、总胆红素、白蛋白、DPN及行走障碍。.
Keywords: Diabetes mellitus, type 2; Diabetic foot; Influencing factors; Recurrence; Ulcer.
Similar articles
-
Analysis of factors influencing the recurrence of diabetic foot ulcers.Skin Res Technol. 2024 Jul;30(7):e13826. doi: 10.1111/srt.13826. Skin Res Technol. 2024. PMID: 38965804 Free PMC article.
-
Influencing factors for the recurrence of diabetic foot ulcers: A meta-analysis.Int Wound J. 2023 May;20(5):1762-1775. doi: 10.1111/iwj.14017. Epub 2022 Nov 17. Int Wound J. 2023. PMID: 36385501 Free PMC article. Review.
-
Risk factors for diabetic foot ulcers: an Albanian retrospective study of inpatients with type 2 diabetes.Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):558-572. doi: 10.26355/eurrev_202201_27883. Eur Rev Med Pharmacol Sci. 2022. PMID: 35113432
-
Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China.Int J Low Extrem Wounds. 2015 Mar;14(1):19-27. doi: 10.1177/1534734614564867. Epub 2015 Jan 8. Int J Low Extrem Wounds. 2015. PMID: 25573978
-
Growth factors for treating diabetic foot ulcers.Cochrane Database Syst Rev. 2015 Oct 28;2015(10):CD008548. doi: 10.1002/14651858.CD008548.pub2. Cochrane Database Syst Rev. 2015. PMID: 26509249 Free PMC article. Review.
Cited by
-
Analysis of factors influencing the recurrence of diabetic foot ulcers.Skin Res Technol. 2024 Jul;30(7):e13826. doi: 10.1111/srt.13826. Skin Res Technol. 2024. PMID: 38965804 Free PMC article.
-
Diabetic foot ulcers risk prediction in patients with type 2 diabetes using classifier based on associations rule mining.Sci Rep. 2024 Jan 5;14(1):635. doi: 10.1038/s41598-023-47576-w. Sci Rep. 2024. PMID: 38182645 Free PMC article.
-
Influencing factors for the recurrence of diabetic foot ulcers: A meta-analysis.Int Wound J. 2023 May;20(5):1762-1775. doi: 10.1111/iwj.14017. Epub 2022 Nov 17. Int Wound J. 2023. PMID: 36385501 Free PMC article. Review.
-
Association between diabetic retinopathy and diabetic foot ulcer in patients with diabetes: A meta-analysis.Int Wound J. 2023 Dec;20(10):4077-4082. doi: 10.1111/iwj.14299. Epub 2023 Aug 9. Int Wound J. 2023. PMID: 37554103 Free PMC article.
-
Incidence and risk factors for amputation in Chinese patients with diabetic foot ulcers: a systematic review and meta-analysis.Front Endocrinol (Lausanne). 2024 Aug 30;15:1405301. doi: 10.3389/fendo.2024.1405301. eCollection 2024. Front Endocrinol (Lausanne). 2024. PMID: 39280008 Free PMC article.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical