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糖尿病患者中足夏科氏神经关节病:足部溃疡对自我报告生活质量的影响。

Midfoot Charcot Neuroarthropathy in Patients With Diabetes: The Impact of Foot Ulceration on Self-Reported Quality of Life.

作者信息

Raspovic Katherine M, Hobizal Kimberlee B, Rosario Bedda L, Wukich Dane K

机构信息

Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW).

Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW)

出版信息

Foot Ankle Spec. 2015 Aug;8(4):255-9. doi: 10.1177/1938640015585957. Epub 2015 May 8.

Abstract

INTRODUCTION

Charcot neuroarthropathy (CN) and diabetic foot ulceration (DFU) are serious complications of diabetes mellitus (DM) that can result in infection, hospitalization, amputation, and have been shown to negatively affect quality of life (QOL). To the best of our knowledge, there are no studies in the literature that have specifically compared QOL in patients with diabetic CN without DFU to a group of patients with diabetic CN and concurrent DFU. The aim of this study was to compare self-reported assessments of QOL in patients with CN to a group of patients with CN and concomitant midfoot ulceration.

MATERIALS AND METHODS

We compared a group of 35 diabetic patients with midfoot CN and no ulcer to a group of 22 diabetic patients with midfoot CN and concurrent DFU. Self-reported outcome was assessed using the Medical Outcome Study Short Form 36 (SF-36) health survey and Foot and Ankle Ability Measure (FAAM).

RESULTS

No significant differences were found when comparing the 2 groups utilizing the SF-36 and FAAM with the exception that CN patients without foot ulcers had lower mean scores on the Bodily Pain Subscale. Both groups demonstrated negative impact on physical QOL and lower extremity function to a greater degree than mental QOL.

CONCLUSION

The presence of ulceration does not appear to significantly impact QOL in patients with CN when compared to patients with CN without ulceration.

LEVELS OF EVIDENCE

Prognostic, Level III: Case control.

摘要

引言

夏科氏神经关节病(CN)和糖尿病足溃疡(DFU)是糖尿病(DM)的严重并发症,可导致感染、住院、截肢,并且已被证明会对生活质量(QOL)产生负面影响。据我们所知,文献中尚无专门比较无DFU的糖尿病性CN患者与患有糖尿病性CN并伴有DFU的患者群体的生活质量的研究。本研究的目的是比较CN患者与患有CN并伴有中足溃疡的患者群体的自我报告生活质量评估。

材料与方法

我们将一组35例患有中足CN且无溃疡的糖尿病患者与一组22例患有中足CN并伴有DFU的糖尿病患者进行了比较。使用医学结局研究简明健康调查36项量表(SF-36)和足踝能力测量量表(FAAM)评估自我报告的结果。

结果

使用SF-36和FAAM比较两组时未发现显著差异,唯一例外的是无足部溃疡的CN患者在身体疼痛分量表上的平均得分较低。两组对身体生活质量和下肢功能的负面影响均大于对心理生活质量的影响。

结论

与无溃疡的CN患者相比,溃疡的存在似乎并未对CN患者的生活质量产生显著影响。

证据水平

预后性,III级:病例对照研究。

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