Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università di Palermo, Palermo, Italy.
Osservatorio Epidemiologico, Dipartimento Salute, Regione Sicilia, Italia.
PLoS One. 2021 Dec 7;16(12):e0259405. doi: 10.1371/journal.pone.0259405. eCollection 2021.
The aim of this study was to analyze changes in the incidence, management and mortality of DFU in Sicilian Type 2 diabetic patients hospitalized between two eras, i.e. 2008-2013 and 2014-2019.
We compared the two eras, era1: 2008-13, era2: 2014-19. In era 1, n = 149, and in era 2, n = 181 patients were retrospectively enrolled.
In the population hospitalized for DFU in 2008-2013, 59.1% of males and 40.9% of females died, whilst in 2014-2019 65.9% of males and 34.1% of females died. Moderate chronic kidney disease (CKD) was significantly higher in patients that had died than in ones that were alive (33% vs. 43%, p < 0.001), just as CKD was severe (14.5% vs. 4%, p < 0.001). Considering all together the risk factors associated with mortality, at Cox regression multivariate analysis only moderate-severe CKD (OR 1.61, 95% CI 1.07-2.42, p 0.021), age of onset greater than 69 years (OR 2.01, 95% CI 1.37-2.95, p <0.001) and eGFR less than 92 ml/min (OR 2.84, 95% CI 1.51-5.34, p 0.001) were independently associated with risk of death.
Patients with DFU have high mortality and reduced life expectancy. Age at onset of diabetic foot ulcer, eGFR values and CKD are the principal risk factors for mortality.
本研究旨在分析西西里岛 2 型糖尿病患者糖尿病足溃疡（DFU）发病率、治疗方法和死亡率在两个时期（2008-2013 年和 2014-2019 年）的变化。
我们比较了这两个时期，时期 1：2008-13 年，时期 2：2014-19 年。在时期 1 中，n=149 例患者，在时期 2 中，n=181 例患者被回顾性纳入研究。
在 2008-2013 年因 DFU 住院的人群中，男性死亡率为 59.1%，女性死亡率为 40.9%，而在 2014-2019 年，男性死亡率为 65.9%，女性死亡率为 34.1%。与存活患者相比，死亡患者的中度慢性肾脏病（CKD）显著更高（33%比 43%，p<0.001），同样 CKD 为严重程度（14.5%比 4%，p<0.001）。考虑到与死亡率相关的所有危险因素，在 Cox 回归多变量分析中，只有中重度 CKD（OR 1.61，95%CI 1.07-2.42，p=0.021）、起病年龄大于 69 岁（OR 2.01，95%CI 1.37-2.95，p<0.001）和 eGFR 小于 92ml/min（OR 2.84，95%CI 1.51-5.34，p=0.001）与死亡风险独立相关。
糖尿病足溃疡患者死亡率高，预期寿命缩短。起病年龄、eGFR 值和 CKD 是死亡的主要危险因素。
