Pemayun Tjokorda Gde Dalem, Naibaho Ridho M
Subdivision of Endocrinology, Metabolism and Diabetes, Department of Medicine, Medical Faculty of Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia.
Resident of Internal Medicine, Medical Faculty of Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia.
Diabet Foot Ankle. 2017 May 17;8(1):1312974. doi: 10.1080/2000625X.2017.1312974. eCollection 2017.
: This study attempted to determine the disease burden in terms of clinical profile and outcome of diabetic foot ulcer (DFU) admissions at a tertiary care hospital in a developing country. : In this descriptive study, the data were collected from the medical record of diabetic patients with foot ulcer who were treated in Dr. Kariadi General Hospital during a 3-year period. The demographic characteristic, type of foot lesion, etiology, isolated microorganism, treatment, and outcome were reviewed. : Foot problems accounted for 16.2% of total diabetic admission ( = 1429). All patients had type 2 diabetes with no gender predominance. The mean age was 54.3 ± 8.6 years and diabetes control was very poor. Before admission, the ulcers had already developed for 4.7 ± 2.9 weeks; however, the majority of patients were unaware of the preceding causes. Ulcers were neuropathic in 42.2% of cases, neuroischemic in 29.9%, and pure ischemic at lesser percentage. More than 70% of ulcers were in Wagner grade ≥3 with infection event in nearly all patients. The most common isolates from culture were Gram-negative bacteria. A total of 98 (36.3%) lower extremity amputations (LEAs) at various level of the foot were carried out, including major LEA in 24 patients and multiple amputations in seven patients. Mortality rate due to DFU reached 10.7%. Diabetic foot problems constitute a source of morbidity, a reason for LEA surgery as well as being a cause of death among patients with diabetes mellitus.
本研究试图根据一个发展中国家一家三级医院糖尿病足溃疡(DFU)入院患者的临床特征和结局来确定疾病负担。
在这项描述性研究中,数据收集自3年期间在卡里阿迪综合医院接受治疗的足部溃疡糖尿病患者的病历。对人口统计学特征、足部病变类型、病因、分离出的微生物、治疗方法和结局进行了回顾。
足部问题占糖尿病入院患者总数的16.2%(n = 1429)。所有患者均为2型糖尿病,无性别优势。平均年龄为54.3±8.6岁,糖尿病控制情况很差。入院前,溃疡已经发展了4.7±2.9周;然而,大多数患者不知道之前的病因。42.2%的病例溃疡为神经病变性,29.9%为神经缺血性,单纯缺血性的比例较低。超过70%的溃疡处于Wagner分级≥3级,几乎所有患者都有感染情况。培养中最常见的分离菌是革兰氏阴性菌。共进行了98例(36.3%)不同足部水平的下肢截肢(LEA),包括24例大截肢和7例多次截肢。DFU导致的死亡率达到10.7%。糖尿病足部问题是糖尿病患者发病的一个来源,是LEA手术的一个原因,也是导致死亡的一个原因。