Department of Endocrinology and Metabolism, Hacettepe University Medical School, Ankara, Turkey.
Endocrine. 2010 Aug;38(1):87-92. doi: 10.1007/s12020-010-9355-z. Epub 2010 Jun 20.
Diabetic foot disease causes important morbidity in diabetic population, and amputation due to diabetic foot disease occurs more often than in general population. We have been evaluating patients with diabetic foot disease in a multidisciplinary approach since year 2000. In the current study, we sought to investigate the change in amputation rate and its predictors in diabetic foot with a multidisciplinary team approach. Seventy-four patients (52 male, 22 female) hospitalised between January 2002 and December 2007 were retrospectively analysed. Sixteen out of 74 have undergone amputation. We found overall amputation rate as 21.6%, which is lower than previously reported from our institution (36.7 and 39.4%, respectively). Major amputations (syme, below-knee, above-knee) were applied to 11 patients (14.9%). A logistic regression model including osteomyelitis, peripheral neuropathy, peripheral vascular disease, hypertension, gangrene and age revealed that gangrene is now the only significant predictor for amputation. Our observations confirm that amputation rate has declined after implementation of a multidisciplinary team work, and risk factors apart from presence of gangrene are no longer amputation predictors in our centre.
糖尿病足病在糖尿病患者中引起重要的发病率，并且由于糖尿病足病导致的截肢比一般人群更为常见。自 2000 年以来，我们一直在采用多学科方法评估糖尿病足病患者。在本研究中，我们旨在探讨多学科团队方法治疗糖尿病足病的截肢率及其预测因素的变化。回顾性分析了 2002 年 1 月至 2007 年 12 月期间住院的 74 例患者（52 例男性，22 例女性）。74 例中有 16 例接受了截肢。我们发现总的截肢率为 21.6%，低于我们机构之前的报告（分别为 36.7%和 39.4%）。11 例患者（14.9%）接受了主要截肢（Syme、膝下、膝上）。包括骨髓炎、周围神经病变、周围血管疾病、高血压、坏疽和年龄在内的逻辑回归模型表明，坏疽是目前唯一的截肢预测因素。我们的观察结果证实，实施多学科团队工作后，截肢率已经下降，除坏疽外的其他危险因素不再是我们中心的截肢预测因素。
