Bekele Firomsa, Chelkeba Legese, Fekadu Ginenus, Bekele Kumera
Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.
Department of Pharmacy, Institute of Health Science, Jimma University, Jimma, Ethiopia.
Ann Med Surg (Lond). 2020 Jan 18;51:17-23. doi: 10.1016/j.amsu.2020.01.005. eCollection 2020 Mar.
Diabetic foot ulcer is one of the complications of diabetes mellitus. The diabetic patients with foot infections especially gangrene require long-term hospitalization and carry the risk of limb amputation. Despite these challenges, there are a scarce studies done on risk factors and no finding on outcomes of diabetic foot ulcers in Ethiopia.
A prospective observational study was conducted among diabetes patients with diabetic foot ulcer at Nekemte referral hospital from March 15 to June 15, 2018.
Of the 115 diabetes foot ulcer patients admitted to Nekemte referral hospital, 64(55.65%) were males and the mean age of participants was 44.4 ± 14.7 years. Fifty-eight (50.43%) of the patients had chronic health problems and 56(48.69%) had diabetic complications. Of patients with complications, 35(30.43%) were undergone amputations. Diabetic foot ulcer grade ≥4 = inappropriate antibiotics use ( = overweight ( = obesity (AOR = 3.020; 95% CI: 2.556, 16.397), poor blood glucose control = and neuropathy = were predictors of amputation up on multivariable logistic regression analysis.
Blood glucose level, higher body mass index, inappropriate antibiotics use, neuropathy and advanced grade of diabetic foot ulcer were independent predictors of amputation. Thus, special emphasis for patients having neuropathy and advanced grade of diabetic foot ulcer as well as weight reduction, managing hyperglycaemia, and appropriate antibiotics prescription practice would decrease untoward effects of diabetic foot ulcer.
糖尿病足溃疡是糖尿病的并发症之一。患有足部感染尤其是坏疽的糖尿病患者需要长期住院治疗,并面临肢体截肢的风险。尽管存在这些挑战,但在埃塞俄比亚,关于糖尿病足溃疡危险因素的研究很少,且未发现其预后情况。
2018年3月15日至6月15日,在 Nekemte 转诊医院对患有糖尿病足溃疡的糖尿病患者进行了一项前瞻性观察研究。
在 Nekemte 转诊医院收治的115例糖尿病足溃疡患者中,64例(55.65%)为男性,参与者的平均年龄为44.4±14.7岁。58例(50.43%)患者有慢性健康问题,56例(48.69%)有糖尿病并发症。在有并发症的患者中,35例(30.43%)接受了截肢手术。多变量逻辑回归分析显示,糖尿病足溃疡≥4级、不适当使用抗生素、超重、肥胖(调整后比值比[AOR]=3.020;95%置信区间[CI]:2.556,16.397)、血糖控制不佳以及神经病变是截肢的预测因素。
血糖水平、较高的体重指数、不适当使用抗生素、神经病变和糖尿病足溃疡的晚期是截肢的独立预测因素。因此,特别关注患有神经病变和晚期糖尿病足溃疡的患者,以及减轻体重、控制高血糖和适当的抗生素处方做法,将减少糖尿病足溃疡的不良影响。