英国特定人群11年间糖尿病截肢病例的减少：多学科团队协作及持续前瞻性审计的益处
Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit.
作者信息
Krishnan Singhan, Nash Fiona, Baker Neil, Fowler Duncan, Rayman Gerry
机构信息
Ipswich Hospital, Diabetes Center, Heath Road, Ipswich, Suffolk IP4 5PD, UK.
出版信息
Diabetes Care. 2008 Jan;31(1):99-101. doi: 10.2337/dc07-1178. Epub 2007 Oct 12.
OBJECTIVE
To assess changes in diabetic lower-extremity amputation rates in a defined relatively static population over an 11-year period following the introduction of a multidisciplinary foot team.
RESEARCH DESIGN AND METHODS
All diabetic patients with foot problems admitted to Ipswich Hospital, a large district general hospital, were identified by twice-weekly surveillance of all relevant in-patient areas and outcomes including amputations recorded.
RESULTS
The incidence of major amputations fell 62%, from 7.4 to 2.8 per 100,000 of the general population. Total amputation rates also decreased (40.3%) but to a lesser extent due to a small increase in minor amputations. Expressed as incidence per 10,000 people with diabetes, total amputations fell 70%, from 53.2 to 16.0, and major amputations fell 82%, from 36.4 to 6.7.
CONCLUSIONS
Significant reductions in total and major amputation rates occurred over the 11-year period following improvements in foot care services including multidisciplinary team work.
目的
评估在引入多学科足部治疗团队后的11年期间，特定相对稳定人群中糖尿病下肢截肢率的变化情况。
研究设计与方法
通过对所有相关住院区域进行每周两次的监测，确定了入住伊普斯威奇医院（一家大型地区综合医院）的所有有足部问题的糖尿病患者，并记录包括截肢在内的结果。
结果
大截肢发生率下降了62%，从每10万人中的7.4例降至2.8例。总截肢率也有所下降（40.3%），但由于小截肢略有增加，下降幅度较小。以每10000名糖尿病患者中的发生率表示，总截肢率下降了70%，从53.2降至16.0，大截肢率下降了82%，从36.4降至6.7。
结论
在包括多学科团队合作在内的足部护理服务改善后的11年期间，总截肢率和大截肢率显著降低。
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