治疗性鞋具磨损对缓解期患者的影响。一项为期 5 年的随访研究。

Effects of wear and tear of therapeutic footwear in patients remission. A 5-year follow-up study.

机构信息

Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid. Instituto, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.

出版信息

Diabetes Res Clin Pract. 2022 Jul;189:109971. doi: 10.1016/j.diabres.2022.109971. Epub 2022 Jun 26.

DOI:10.1016/j.diabres.2022.109971

PMID:35760155

Abstract

AIMS

To assesses the relationship between the wear and tear of therapeutic footwear (TF) and the risk of recurrence in diabetes remission patients.

METHODS

Remission patients (N = 115) participated in this 5-year prospective study in a specialized Diabetic Foot Unit between October 2016 and January 2022. Patients' TF was assessed in a three-month interval from Day 0 until ulcer recurrence was found. Primary outcome measure was based on the recurrent event in the forefoot.

RESULTS

A total of 82 patients (71.3%) renewed their TF, and 33 patients (28.7%) did not renew their TF during the follow-up period. Patients who failed to renew their TF group experienced more recurrent events (22 vs 14, p <.001, CI [0.04-0.259]) and minor amputations (11 vs 8, p =.002, CI [0.07-0.6]). Both groups showed different recurrence-free survival median times of 205.5 [Interquartile range (IQR) - 188-222] weeks and 89.9 [IQR - 53-126] weeks. Patients who did not renew their TF increased their risk of suffering from a recurrent event in the Cox regression model (p <.001, CI [0.03-0.38], Hazzard Ratio 0.147).

CONCLUSIONS

Patients who renewed their TF because of wear and tear experienced lower recurrences and minor amputations.

摘要

目的

评估治疗性鞋（TF）的磨损与糖尿病缓解患者复发风险之间的关系。

方法

缓解期患者（N=115）参加了这项为期 5 年的前瞻性研究，该研究于 2016 年 10 月至 2022 年 1 月在专门的糖尿病足科进行。在从第 0 天开始的三个月间隔内评估患者的 TF，直到发现溃疡复发。主要观察指标基于前足的复发性事件。

结果

共有 82 名患者（71.3%）更换了 TF，33 名患者（28.7%）在随访期间未更换 TF。未能更换 TF 组的患者经历了更多的复发事件（22 次与 14 次，p<.001，CI [0.04-0.259]）和小截肢（11 次与 8 次，p=.002，CI [0.07-0.6]）。两组的无复发生存中位时间分别为 205.5 [四分位距（IQR）-188-222]周和 89.9 [IQR - 53-126]周。在 Cox 回归模型中，未更换 TF 的患者发生复发事件的风险增加（p<.001，CI [0.03-0.38]，Hazzard 比 0.147）。