Bortoletto Maira Sayuri Sakay, de Andrade Selma Maffei, Matsuo Tiemi, Haddad Maria do Carmo Lourenço, González Alberto Durán, Silva Ana Maria Rigo
Department of Public Health, Postgraduate Program of Public Health, State University of Londrina, Brazil.
Department of Public Health, Postgraduate Program on Public Health, State University of Londrina, Avenida Robert Koch, 60 CEP-8603835, Brazil.
Prim Care Diabetes. 2014 Apr;8(1):71-6. doi: 10.1016/j.pcd.2013.04.003. Epub 2013 Apr 30.
To identify the prevalence of higher risk of foot ulceration and associated factors among patients with diabetes mellitus (DM) at primary health care services.
Individuals with DM, registered at primary health care services in a municipality in southern Brazil, were interviewed and underwent foot examinations. Their risk of ulceration was classified in accordance with the recommendations of the International Working Group on the Diabetic Foot. Poisson bivariate and multivariate analyses were performed and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated.
The prevalence of higher risk of foot ulceration among the 337 interviewees was 27.9% (95% CI 23.1-32.9). The following factors were associated with this risk: having been diagnosed with DM for more than 10 years (Adjusted-PR 1.669; 95% CI 1.175-2.373; p=0.004); having had previous diagnoses of acute myocardial infarction (Adjusted-PR 1.873; 95% CI 1.330-2.638; p<0.001) and stroke (Adjusted-PR 1.684; 95% CI 1.089-2.604; p=0.019); presenting interdigital mycosis (Adjusted-PR 1.539; 95% CI 1.030-2.300; p=0.035) and calluses (Adjusted-PR 1.654; 95% CI 1.117-2.451; p=0.012).
The prevalence of higher risk of ulceration was high, which reinforces the importance of continued education for health care professionals in order to prevent complications in the feet of these patients.
确定在初级卫生保健服务机构中,糖尿病患者足部溃疡高风险的患病率及相关因素。
对在巴西南部一个市的初级卫生保健服务机构登记的糖尿病患者进行访谈并进行足部检查。根据糖尿病足国际工作组的建议对其溃疡风险进行分类。进行了泊松双变量和多变量分析,并计算了调整患病率比(PR)和95%置信区间(CI)。
337名受访者中足部溃疡高风险的患病率为27.9%(95%CI 23.1 - 32.9)。以下因素与该风险相关:糖尿病诊断超过10年(调整后PR 1.669;95%CI 1.175 - 2.373;p = 0.004);既往有急性心肌梗死诊断(调整后PR 1.873;95%CI 1.330 - 2.638;p < 0.001)和中风(调整后PR 1.684;95%CI 1.089 - 2.604;p = 0.019);存在指间癣(调整后PR 1.539;95%CI 1.030 - 2.300;p = 0.035)和胼胝(调整后PR 1.654;95%CI 1.117 - 2.451;p = 0.012)。
溃疡高风险的患病率较高,这强化了对医护人员进行继续教育以预防这些患者足部并发症的重要性。