Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Dijon, France.
Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France.
J Wound Care. 2021 Oct 2;30(10):804-808. doi: 10.12968/jowc.2021.30.10.804.
Foot ulcers are a common complication of diabetes and are associated with an increase in lower limb amputation and death. Early referral to a specialised unit is recommended. The aim of this study was to assess the characteristics of new-patient referrals to specialised diabetes foot care units across Europe and to determine the factors involved in delayed referral.
In this prospective observational study, consecutive patients with a new foot ulcer presenting to nine diabetic foot centres in five European countries (France, Germany, Italy, Spain and the UK) were included.
Some 25% of the 332 patients included had presented with a foot ulcer >3 months before referral to the participating foot clinic. Compared with patients referred earlier, patients with a long time to referral (>3 months) were older (p=0.006) and had a less severe wound according to Infectious Diseases Society of America (IDSA) classification (p=0.003) and University of Texas classification (grade D=infection + peripheral artery disease, p=0.004).
The proportion of patients with a diabetic foot ulcer (DFU) referred to a specialised unit >3 months after the beginning of the ulcer remained high throughout Europe. Patients with severe DFU were, however, referred more quickly by front line health professionals. Primary care professionals need to be made aware of the importance of early referral to a specialised unit in order to improve the management of foot disease in patients with diabetes.
The authors have no conflicts of interest to declare.
足部溃疡是糖尿病的常见并发症，与下肢截肢和死亡风险增加有关。建议尽早向专门的医疗单位转介。本研究旨在评估欧洲专门的糖尿病足护理单位新患者转介的特征，并确定延迟转介的相关因素。
本前瞻性观察性研究纳入了 9 个位于 5 个欧洲国家（法国、德国、意大利、西班牙和英国）的糖尿病足中心连续就诊的新发足部溃疡患者。
332 例患者中，25%的患者在转诊至参与的足部诊所前足部溃疡已存在 3 个月以上。与更早转诊的患者相比，延迟转诊（>3 个月）的患者年龄更大（p=0.006），根据美国感染病学会（IDSA）分类（p=0.003）和德克萨斯大学分类（D 级=感染+外周动脉疾病，p=0.004），其溃疡严重程度较轻。
在整个欧洲，有相当比例的糖尿病足溃疡（DFU）患者在溃疡发生 3 个月后才被转介到专门的医疗单位。然而，病情严重的 DFU 患者更能被一线卫生保健专业人员迅速转介。需要让初级保健专业人员意识到向专门医疗单位尽早转介的重要性，以改善糖尿病患者足部疾病的管理。
作者无利益冲突声明。
