Acar Erdinc, Kacıra Burkay Kutluhan
Orthopedist and Hand Surgeon, Division of Hand and Upper Extremity Surgery, Department of Orthopaedics and Traumatology, Konya Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
Assistant Professor, Department of Orthopedics and Traumatology, Konya Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
J Foot Ankle Surg. 2017 Nov-Dec;56(6):1218-1222. doi: 10.1053/j.jfas.2017.06.004. Epub 2017 Jul 29.
In the present study, we aimed to identify the comorbidities that would be predictive of requiring lower extremity amputation or reamputation for diabetic foot wounds. We performed a retrospective review of 132 consecutive patients who had undergone lower extremity amputations (110 patients) or reamputations (22 patients) for diabetic wounds from January 2013 to March 2016. We used multivariate logistic regression to calculate the odds ratios (ORs) for amputation and reamputation for various comorbidities. The ORs of undergoing amputation were greatest for adult males (OR 5.12, 95% confidence interval [CI] 1.56 to 13.04; p = .05) and those with longer term diabetes (OR 4.22, 95% CI 2.01 to 12.95; p = .05), wound infection (OR 3.94, 95% CI 1.04 to 9.00; p = .05), diabetic neuropathy (OR 3.53, 95% CI 1.07 to 9.11; p = .05), and a positive history of smoking (OR 3.04, 95% CI 1.55 to 9.89; p = .05). Similarly, the ORs of undergoing reamputation were greatest for adult males (OR 4.06, 95% CI 1.02 to 12.08; p = .05) and those with longer term diabetes (OR 3.67, 95% CI 1.94 to 11.42; p = .05), wound infection (OR 3.12; 95% CI 0.9 to 8.32; p = .05), diabetic neuropathy (OR 3.01, 95% CI 0.92 to 8.54; p = .05), and a positive history of smoking (OR 2.89, 95% CI 1.09 to 9.42; p = .05). The early identification of these comorbidities could help determine which patients are most likely to require amputation or reamputation.
在本研究中，我们旨在确定哪些合并症可预测糖尿病足伤口患者需要进行下肢截肢或再次截肢。我们对2013年1月至2016年3月期间因糖尿病伤口接受下肢截肢（110例患者）或再次截肢（22例患者）的132例连续患者进行了回顾性研究。我们使用多因素逻辑回归分析来计算各种合并症患者截肢和再次截肢的比值比（OR）。成年男性（OR 5.12，95%置信区间[CI] 1.56至13.04；p = 0.05）、糖尿病病程较长者（OR 4.22，95% CI 2.01至12.95；p = 0.05）、伤口感染（OR 3.94，95% CI 1.04至9.00；p = 0.05）、糖尿病神经病变（OR 3.53，95% CI 1.07至9.11；p = 0.05）以及有吸烟史者（OR 3.04，95% CI 1.55至9.89；p = 0.05）截肢的OR最高。同样，成年男性（OR 4.06，95% CI 1.02至12.08；p = 0.05）、糖尿病病程较长者（OR 3.67，95% CI 1.94至11.42；p = 0.05）、伤口感染（OR 3.12；95% CI 0.9至8.32；p = 0.05）、糖尿病神经病变（OR 3.01，95% CI 0.92至8.54；p = 0.05）以及有吸烟史者（OR 2.89，95% CI 1.09至9.42；p = 0.05）再次截肢的OR最高。早期识别这些合并症有助于确定哪些患者最有可能需要截肢或再次截肢。
