Doria Montserrat, Viadé Jordi, Palomera Elisabet, Pérez Ricard, Lladó Melcior, Costa Elisabet, Huguet Teresa, Reverter Jordi Lluís, Serra-Prat Mateu, Franch-Nadal Josep, Mauricio Dídac
Department of Endocrinology and Nutrition, University Hospital & Health Sciences Research Institute Germans Trias i Pujol, Badalona, Spain; Diabetic Foot Unit, University Hospital Arnau de Vilanova, Lleida, Spain.
Department of Endocrinology and Nutrition, University Hospital & Health Sciences Research Institute Germans Trias i Pujol, Badalona, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2018 Nov;65(9):479-485. doi: 10.1016/j.endinu.2018.06.004. Epub 2018 Aug 11.
To assess the clinical characteristics of patients with Charcot neuroarthropathy (CN) in Spain and to identify predictors for CN-related complications.
A retrospective study was conducted at five tertiary hospitals with diabetic foot care units in Spain. Data were collected from 83 patients, including demographic profiles, foot factors, diabetes characteristics, and presence of microvascular and macrovascular comorbidity, and a podiatric examination was also performed. Logistic regression analyses were used to determine significant predictors of the predefined clinical events.
Signs of diabetic neuropathy were found in almost all patients (98.9%) at the initial assessment, approximately half of them had diabetic retinopathy or nephropathy (61.5% and 51.8%, respectively), and peripheral artery disease was uncommon (8.6%). Thirty-eight patients (47.5%) experienced one or more relevant clinical events: 22 (27.5%) a new foot ulcer; 7 (8.7%) a major amputation; 20 (25%) were admitted to hospital; and 4 (5%) died. Only the presence of diabetic nephropathy was independently associated to development of any of the complications studied (p = 0.009; odds ratio = 3.37; 95% CI: 1.12-10.1).
Almost half the patients with CN attending specialised foot care units in tertiary hospitals experienced short-term CN-associated complications, and the risk was 3 times higher in those with a history of diabetic nephropathy.
评估西班牙夏科氏神经关节病（CN）患者的临床特征，并确定CN相关并发症的预测因素。
在西班牙五家设有糖尿病足护理单元的三级医院进行了一项回顾性研究。收集了83例患者的数据，包括人口统计学资料、足部因素、糖尿病特征以及微血管和大血管合并症的情况，并进行了足病检查。采用逻辑回归分析来确定预定义临床事件的显著预测因素。
在初始评估时，几乎所有患者（98.9%）都有糖尿病神经病变的体征，其中约一半有糖尿病视网膜病变或肾病（分别为61.5%和51.8%），外周动脉疾病不常见（8.6%）。38例患者（47.5%）发生了一种或多种相关临床事件：22例（27.5%）出现新的足部溃疡；7例（8.7%）进行了大截肢；20例（25%）住院；4例（5%）死亡。只有糖尿病肾病的存在与所研究的任何并发症的发生独立相关（p = 0.009；比值比 = 3.37；95%可信区间：1.12 - 10.1）。
在三级医院的专科足部护理单元就诊的CN患者中，近一半经历了短期的CN相关并发症，有糖尿病肾病病史的患者发生并发症的风险高3倍。
