Otiniano Max E, Du Xianglin, Ottenbacher Kenneth, Black Sandra A, Markides Kyriakos S
Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555, USA.
J Diabetes Complications. 2003 Mar-Apr;17(2):59-65. doi: 10.1016/s1056-8727(02)00175-7.
This study was designed to determine the incidence and prevalence of amputations in diabetic Mexican American elders and to identify correlates of lower extremity amputations. Data for this study came from baseline and two follow-up interviews of the Hispanic Established Population for the Epidemiological Study of the Elderly (EPESE) conducted in five southwestern states (Texas, California, New Mexico, Colorado and Arizona) in 1993-1994. Of the 3050 subjects aged 65 and older, 690 reported diabetes, and from these, 60 (8%) reported having at least one lower extremity amputation. Losing a leg was the most common type of amputation (53%). Twelve percent of respondents reported a new amputation and 40% of amputees reported a second amputation during follow-up. Mortality among amputees was 46% during a 5-year follow-up. Multiple logistic regression analysis showed that being male and having eye problems, hip fracture and diabetes for 10 or more years were significantly associated with lower extremity amputations at baseline, whereas obesity, stroke and 10 or more years with diabetes were significantly associated with new amputations at 5-year follow-up. Gender and disease history were associated with lower extremity amputations at baseline and follow-up. These variables may be useful in developing patient education and intervention programs.
本研究旨在确定墨西哥裔美国糖尿病老年患者截肢的发病率和患病率,并找出下肢截肢的相关因素。本研究的数据来自1993 - 1994年在五个西南部州(得克萨斯州、加利福尼亚州、新墨西哥州、科罗拉多州和亚利桑那州)对西班牙裔老年人流行病学研究的既定人群(EPESE)进行的基线调查和两次随访访谈。在3050名65岁及以上的受试者中,690人报告患有糖尿病,其中60人(8%)报告至少有一次下肢截肢。腿部截肢是最常见的截肢类型(53%)。12%的受访者报告在随访期间有新的截肢,40%的截肢者报告有第二次截肢。在5年的随访期间,截肢者的死亡率为46%。多元逻辑回归分析表明,男性、有眼部问题、髋部骨折以及患糖尿病10年或更长时间与基线时的下肢截肢显著相关,而肥胖、中风以及患糖尿病10年或更长时间与5年随访时的新截肢显著相关。性别和疾病史在基线和随访时均与下肢截肢有关。这些变量可能有助于制定患者教育和干预计划。