Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Belgium.
Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Belgium; ASTARC, Division of Thoracic and Vascular Surgery, University of Antwerp, Belgium.
Clin Nutr ESPEN. 2021 Jun;43:335-341. doi: 10.1016/j.clnesp.2021.03.029. Epub 2021 Apr 15.
To estimate the prevalence of protein-energy malnutrition in people admitted for a diabetic foot ulcer (DFU) and to assess the relationship between malnutrition and DFU severity and outcome.
This prospective, observational cohort study included individuals consecutively admitted for a DFU between July 2016 and September 2019. The Global Leadership Initiative on Malnutrition (GLIM) criteria determined the prevalence of malnutrition. The SINBAD score reflected DFU severity. Outcome was evaluated at discharge and at 6 months. The independent contribution of nutritional status on DFU severity and outcome was investigated using logistic regression analysis.
A total of 110 patients were included. Malnutrition, as defined by the GLIM criteria, was diagnosed in 26 cases; malnutrition was moderate in 9 and severe in 17. DFU severity differed significantly between subjects with malnutrition versus without malnutrition (SINBAD: 3.85 vs. 3.81, p = 0.012). Logistic regression analysis showed that severe malnutrition (p = 0.015) and hemoglobin level (p = 0.003) were independently linked to DFU severity. At 6-month follow-up, 39 DFU were healed, 36 patients had undergone an amputation (32 minor, 4 major) and 8 had died. No differences were noted in outcome at discharge or at 6 months according to nutritional status.
In 24% of patients, malnutrition was diagnosed. Severely malnourished individuals presented with more severe ulcers. However, malnutrition had no impact on the short-term outcome of a DFU.
评估因糖尿病足溃疡（DFU）入院患者的蛋白质-能量营养不良发生率，并评估营养不良与 DFU 严重程度和结局的关系。
本前瞻性观察性队列研究纳入 2016 年 7 月至 2019 年 9 月连续因 DFU 入院的患者。采用全球营养不良倡议（GLIM）标准确定营养不良的发生率。SINBAD 评分反映 DFU 严重程度。结局在出院时和 6 个月时进行评估。采用 logistic 回归分析探讨营养状况对 DFU 严重程度和结局的独立影响。
共纳入 110 例患者。根据 GLIM 标准，26 例诊断为营养不良；9 例为中度营养不良，17 例为重度营养不良。营养不良患者与无营养不良患者的 DFU 严重程度存在显著差异（SINBAD：3.85 比 3.81，p=0.012）。logistic 回归分析显示，重度营养不良（p=0.015）和血红蛋白水平（p=0.003）与 DFU 严重程度独立相关。6 个月随访时，39 例 DFU 愈合，36 例患者行截肢术（32 例小截肢，4 例大截肢），8 例死亡。根据营养状况，出院时或 6 个月时的结局无差异。
24%的患者诊断为营养不良。重度营养不良患者的溃疡更为严重。然而，营养不良对 DFU 的短期结局无影响。
