Pedras Susana, Meira-Machado Luís, Couto de Carvalho André, Carvalho Rui, Pereira M Graça
School of Psychology, University of Minho, Braga, Portugal.
Department of Mathematics and Applications, Faculty of Sciences, University of Minho, Guimarães, Portugal.
J Ment Health. 2022 Dec;31(6):792-800. doi: 10.1080/09638237.2020.1836554. Epub 2020 Oct 24.
One of the most serious complications of diabetes mellitus (DM) is a diabetic foot ulcer (DFU), with lower extremity amputation (LEA).
This study aims to explore the role of anxiety and depression on mortality, reamputation and healing, after a LEA due to DFU.
A sample of 149 patients with DFU who underwent LEA answered the Hospital Anxiety and Depression Scale and a sociodemographic and clinical questionnaire. This is a longitudinal and multicenter study with four assessment moments that used Cox proportional hazards models adjusted for demographic and clinical variables.
Rate of mortality, reamputation and healing, 10 months after LEA were 9.4%, 27.5% and 61.7%, respectively. Anxiety, at baseline, was negatively associated with healing. However, depression was not an independent predictor of mortality. None of the psychological factors was associated with reamputation.
Results highlight the significant contribution of anxiety symptoms at pre-surgery, to healing after a LEA. Suggestions for psychological interventions are made.
糖尿病（DM）最严重的并发症之一是糖尿病足溃疡（DFU），常伴有下肢截肢（LEA）。
本研究旨在探讨焦虑和抑郁在因DFU导致LEA后的死亡率、再次截肢和愈合方面所起的作用。
149例接受LEA的DFU患者样本回答了医院焦虑抑郁量表以及一份社会人口统计学和临床问卷。这是一项纵向多中心研究，有四个评估时间点，使用了针对人口统计学和临床变量进行调整的Cox比例风险模型。
LEA后10个月的死亡率、再次截肢率和愈合率分别为9.4%、27.5%和61.7%。基线时的焦虑与愈合呈负相关。然而，抑郁并非死亡率的独立预测因素。没有任何心理因素与再次截肢相关。
结果突出了术前焦虑症状对LEA后愈合的显著影响。并提出了心理干预建议。
