Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea.
Department of Plastic Surgery, Korea University Guro Hospital, Seoul, South Korea.
Diabetes Res Clin Pract. 2019 Dec;158:107905. doi: 10.1016/j.diabres.2019.107905. Epub 2019 Oct 29.
The purpose of this study was to investigate the risk factors for major amputation in patients hospitalized with diabetic forefoot ulcers.
Between January 2003 and December 2018, a total of 1792 diabetic patients were admitted to the diabetic wound center for the management of diabetic foot ulcers. Among the patients, 1032 diabetic patients with forefoot ulcers were included in this study. Nine hundred and eighty-three patients (95%) healed without major amputations while 49 patients (5%) healed after major amputations. Data related to 88 potential risk factors including demographics, ulcer condition, vascularity, bioburden, neurology, and serology were collected from the patients in these two groups for comparison.
Among the 88 potential risk factors, 34 showed statistically significant differences between the two groups. In the univariate analysis of 88 risk factors, 33 showed statistically significant differences. In stepwise multiple logistic regression analysis, four of the 33 risk factors remained statistically significant. The multivariate-adjusted odds ratios for gender, magnesium levels, platelet levels, and glycated hemoglobin (HbA1c) levels were 8.216, 2.480, 1.009, and 0.570, respectively.
Risk factors for major amputation in patients hospitalized with diabetic forefoot ulcers include male gender, increased magnesium, increased platelet levels, and low levels of HbA1c.
本研究旨在探讨住院糖尿病前足溃疡患者发生主要截肢的风险因素。
2003 年 1 月至 2018 年 12 月期间，共有 1792 例糖尿病患者因糖尿病足溃疡入住糖尿病创面中心。在这些患者中，有 1032 例糖尿病前足溃疡患者纳入本研究。983 例（95%）患者未经主要截肢而愈合，49 例（5%）患者经主要截肢后愈合。收集这两组患者 88 个潜在风险因素的相关数据，包括人口统计学、溃疡状况、血管状况、生物负荷、神经病变和血清学。
在 88 个潜在风险因素中，有 34 个在两组间存在统计学差异。在对 88 个风险因素进行单因素分析时，有 33 个存在统计学差异。在逐步多元逻辑回归分析中，33 个风险因素中有 4 个具有统计学意义。性别、镁水平、血小板水平和糖化血红蛋白（HbA1c）水平的多变量调整比值比分别为 8.216、2.480、1.009 和 0.570。
住院糖尿病前足溃疡患者发生主要截肢的风险因素包括男性、镁升高、血小板水平升高和 HbA1c 降低。
