初发糖尿病足溃疡患者的生存预后研究

Survival outcomes of 522 hospitalized patients with new-onset diabetic foot ulcers

摘要:

目的 研究初发糖尿病足溃疡患者生存预后及影响生存预后因素。方法 选取2010 年1 月-2016 年12 月于该院住院的609 例初发糖尿病足溃疡（DFU）患者，随访至2017 年6 月，以获得生存状况及死亡时间。 结果 522 例（85.7%）完成随访，平均（3.475±1.690）年；存活288 例（55.2%），死亡234 例（44.8%）；平 均生存时间（4.720±0.120）年，中位生存期5.030 年，1、3 和5 年累积生存率分别为89.8%、72.5% 和50.4%。 与存活组比较，死亡组患者年龄大、糖尿病病程长、足部病变程度重，糖尿病肾病、周围动脉病变、心血管 病患病率高，差异有统计学意义（P <0.05）。年龄、Wagner 分级、糖尿病肾病、周围动脉病变、心血管病是 DFU 患者死亡的高危因素。结论 糖尿病患者初发足溃疡时已合并多种糖尿病慢性并发症及合并症，病死率 高，平均生存期短，应对死亡高危因素进行早期干预。

Abstract:

Objective To investigate the survival outcomes of 522 type 2 diabetic patients with new-onset diabetic foot ulcers (DFU). Methods A total of 609 cases of type 2 diabetic patients with new-onset foot ulcers admitted to Hainan Provincial People’s Hospital from January 2010 to December 2016 were followed up till June 2017. Their survival status and death time were recorded. Results Of the 609 patients, 522 (85.7%) patients fully experienced the follow-up, with a mean follow-up period of (3.475 ± 1.690) years. Among the 522 patients, 288 patients (55.2%) survived, 234 patients (44.8%) died. The mean survival time was (4.72 ± 0.12) years, and the median survival time was 5.03 years, and the 1-, 3- and 5-year cumulative survival rates were 89.8%, 72.5% and 50.4% respectively. Compared with the survival group, the patients in the deceased group had older age, longer diabetic duration, much more serious foot situations, higher incidences of diabetic nephropathy, peripheral arterial disease and cardiovascular disease (P < 0.05). Age, Wagner grade, diabetic nephropathy, peripheral arterial disease and cardiovascular disease were the risk factors for death in the DFU patients. Conclusions Diabetic patients with newonset foot ulcers have multiple diabetic complications, high mortality and short average lifetime. Early interventions should be taken to deal with the mortality risk factors.