Gordon Susan J, Murray Susie G, Sutton Trudie, Coulombe Marie-Michelle, James Sally J, Van Zanten Malou, Lawson Joanne K, Moffatt Christine
1 College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
2 Centre for Research and Implementation of Clinical Practice, London, United Kingdom.
Lymphat Res Biol. 2019 Apr;17(2):173-177. doi: 10.1089/lrb.2018.0087.
Australia was one of nine participating countries in the epidemiology Phase II Lymphoedema Impact and Prevalence - International (LIMPRINT) project to determine the number of people with chronic edema (CO) in local health services. Data collection occurred through questionnaire-based interviews and clinical assessment with provided LIMPRINT tools. Four different types of services across three states in Australia participated. A total of 222 adults participated with an age range from 22 to 102 years, and 60% were female. Site 1 included three residential care facilities (54% of participants had swelling), site 2 was community-delivered aged care services (24% of participants had swelling), site 3 was a hospital setting (facility-based prevalence study; 28% of participants had swelling), and site 4 was a wound treatment center (specific patient population; 100% of participants had swelling). Of those with CO or secondary lymphedema, 93% were not related to cancer, the lower limbs were affected in 51% of cases, and 18% of participants with swelling reported one or more episodes of cellulitis in the previous year. Wounds were identified in 47% ( = 105) of all participants with more than half of those with wounds coming from the dedicated wound clinic. Leg/foot ulcer was the most common type of wound (65%, = 68). Distances between services, lack of specialized services, and various state funding models contribute to inequities in CO treatment. Understanding the high number of noncancer-related CO presentations will assist health services to provide timely effective care and improve referral pathways.
澳大利亚是参与“淋巴水肿影响与患病率——国际(LIMPRINT)项目”第二阶段流行病学研究的九个国家之一,该项目旨在确定当地医疗服务中慢性水肿(CO)患者的数量。数据收集通过基于问卷的访谈以及使用提供的LIMPRINT工具进行临床评估来完成。澳大利亚三个州的四种不同类型的服务机构参与了研究。共有222名成年人参与,年龄范围在22岁至102岁之间,其中60%为女性。地点1包括三个住宿护理机构(54%的参与者有肿胀情况),地点2是社区提供的老年护理服务(24%的参与者有肿胀情况),地点3是医院环境(基于机构的患病率研究;28%的参与者有肿胀情况),地点4是伤口治疗中心(特定患者群体;100%的参与者有肿胀情况)。在患有CO或继发性淋巴水肿的患者中,93%与癌症无关,51%的病例下肢受到影响,18%有肿胀情况的参与者报告在前一年发生过一次或多次蜂窝织炎。在所有参与者中,47%(n = 105)被发现有伤口,其中一半以上有伤口的参与者来自专门的伤口诊所。腿部/足部溃疡是最常见的伤口类型(65%,n = 68)。服务机构之间的距离、缺乏专业服务以及各种州资金模式导致了CO治疗的不平等。了解大量与癌症无关的CO病例将有助于医疗服务机构提供及时有效的护理并改善转诊途径。