Grupo de Investigación en Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru; Servicio de Endocrinología, Hospital María Auxiliadora, Lima, Peru; Alianza para el Salvataje del Pie Diabético, Lima, Peru.
Servicio de Endocrinología, Centro Médico Naval "Cirujano Mayor Santiago Távara", Lima, Peru; Alianza para el Salvataje del Pie Diabético, Lima, Peru; Escuela de Post grado, Universidad Peruana Cayetano Heredia, Lima, Peru.
Prim Care Diabetes. 2021 Jun;15(3):480-487. doi: 10.1016/j.pcd.2021.02.009. Epub 2021 Mar 1.
To evaluate the burden of diabetic foot complications amongst inpatients in Peru.
Cross-sectional multicenter study, performed in public hospitals, in one-day enrollment between October and December 2018.
We included 8346 patients from 39 national hospitals. Diabetic foot (DF) inpatient point prevalence was 2.8% (CI 95% 2.4-3.1), and DF point prevalence among Diabetes Mellitus (DM) inpatients was 18.9% (CI 95% 16.7-21.1). DF prevalence was higher in jungle and coastal hospitals than highlands ones, and there was no difference according to its care complexity level. Of the 234 patients with DF, 73% were males, age average was 62 ± 12 years, with DM mean time duration of 15 ± 9.9 years. Regarding to DF etiology, 91% and 68% had some degree of peripheral neuropathy and peripheral artery disease, respectively. According to the Infectious Diseases Society of America criteria, 61% presented moderate to severe infections, and 40% had bone involvement. Debridement within 48 h was performed in 36% of sepsis cases.
Peru has a substantial burden of DF disease, with a greater share of that burden falling on less equipped hospitals in the country's jungle and coastal regions. Interdisciplinary teams and pathways may improve the time of surgical debridement in the highest risk patients.
评估秘鲁住院患者糖尿病足并发症的负担。
这是一项在秘鲁 39 家公立医院开展的、于 2018 年 10 月至 12 月期间进行的 1 天入组的横断面多中心研究。
共纳入了 8346 名来自 39 家国家医院的患者。糖尿病足（DF）住院患者的现患率为 2.8%（95%CI 95% 2.4-3.1），糖尿病住院患者中糖尿病足的现患率为 18.9%（95%CI 95% 16.7-21.1）。DF 的患病率在丛林和沿海医院高于高原医院，但与护理复杂程度无关。在 234 例 DF 患者中，73%为男性，平均年龄为 62±12 岁，糖尿病平均病程为 15±9.9 年。就 DF 的病因而言，91%和 68%分别有不同程度的周围神经病变和外周动脉疾病。根据美国传染病学会的标准，61%的患者存在中度至重度感染，40%的患者有骨骼受累。在败血症患者中，36%的患者在 48 小时内进行了清创。
秘鲁的 DF 疾病负担沉重，在该国的丛林和沿海地区，医疗设备较差的医院承担了更大的负担。多学科团队和途径可能会缩短高危患者的手术清创时间。
