Vinkel Julie, Lohse Nicolai, Hyldegaard Ole
Dan Med J. 2019 Feb;66(2).
Patients with diabetic foot ulcers (DFU) suffer from diabetes-related complications and comor-bidities. Hyperbaric oxygen therapy (HBOT) is a treatment modality with limited capacity used in the treatment of DFUs. It is important to ensure that HBOT is offered to patients who are suitable for this treatment regarding effect, compliance and life expectancy. The objective of the present study was to describe the population of patients with DFU who were referred to HBOT in Denmark in the 1999-2016 period.
All patients with DFU who were treated at the HBOT chamber in Copenhagen during the study period were considered. Patients with an invalid social security number or an incorrect diagnosis were excluded. Data on comor-bidities, amputation and death were extracted from the Danish National patient Registry and the Danish Civil Registration System. Continuous data were described as median values and binary data were described as proportions. The probability estimate for survival and amputation was investigated by constructing Kaplan-Meier curves.
The cohort included 148 patients. Patients were mainly referred from the Capital Region (92%) and multi-disciplinary wound care centres were the primary referring departments (67%). Comorbidity rates were high with an initial median Charlson Comorbidity Index score of five. The five-year amputation and mortality estimates after referral were 73.5% and 51.8%, respectively.
The study showed that Danish DFU patients who are offered HBOT are in advanced stages of their disease, and the referral hinges on local factors such as geography and the referring source rather than on standardised procedures.
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糖尿病足溃疡（DFU）患者患有与糖尿病相关的并发症和合并症。高压氧疗法（HBOT）是一种用于治疗DFU的治疗方式，但其应用能力有限。确保将HBOT提供给在疗效、依从性和预期寿命方面适合这种治疗的患者非常重要。本研究的目的是描述1999年至2016年期间在丹麦被转诊接受HBOT治疗的DFU患者群体。
研究期间在哥本哈根高压氧治疗室接受治疗的所有DFU患者均被纳入研究。排除社会保障号码无效或诊断错误的患者。从丹麦国家患者登记处和丹麦民事登记系统中提取合并症、截肢和死亡数据。连续数据以中位数表示，二元数据以比例表示。通过构建Kaplan-Meier曲线研究生存和截肢的概率估计。
该队列包括148名患者。患者主要来自首都地区（92%），多学科伤口护理中心是主要的转诊科室（67%）。合并症发生率很高，初始Charlson合并症指数中位数为5分。转诊后的五年截肢和死亡率估计分别为73.5%和51.8%。
该研究表明，接受HBOT治疗的丹麦DFU患者处于疾病晚期，转诊取决于地理和转诊来源等当地因素，而非标准化程序。
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