İstanbul Başakşehir Çam ve Sakura Şehir Eğitim ve Araştırma Hastanesi, Spor Travmatolojisi, Artroskopi, Omuz ve Dirsek Cerrahisi Bölümü, 34480 Başakşehir, İstanbul, Türkiye.
Jt Dis Relat Surg. 2023;34(1):115-120. doi: 10.52312/jdrs.2023.818. Epub 2023 Jan 6.
The aim of this study was to evaluate the factors that influenced one-year and five-year mortality and to compare major and minor amputations in diabetic patients with comorbidities.
Between February 2008 and November 2014, a total of 201 type 2 diabetic foot patients (147 males, 54 females; median age: 65.99 years; range, 50 to 92 years) who underwent amputation were retrospectively analyzed. The patients were divided into two groups according to their initial amputation level: Group 1 (n=100), minor amputation group, which included the distal region of the ankle joint and Group 2 (n=101), major amputation group, which included trans-tibial amputation, trans-femoral amputation and hip disarticulation. Clinical data including patients' demographic features, re-amputation degree, length of hospitalization, hyperbaric oxygen therapy, comorbidities, blood parameters, and survival rates were recorded.
The regression analysis of one-year mortality found that the presence of cerebrovascular disease increased death by 2.463 times (p=0.002). Minor amputation increased mortality by 2.284 (p=0.006), and each unit increase in patient age increased mortality by 1.05 (p=0.008). Chronic renal failure increased death by 3.164 times (p<0.001) in the five-year mortality regression analysis.
Minor amputations have an effect on one-year mortality, as do cerebrovascular disease and age. On the other hand, chronic renal failure has a negative impact on five-year mortality. Minor amputations may have a detrimental effect on mortality due to the ongoing progression of diabetic foot disease and the involvement of comorbidities. Comorbidities associated with amputations of the diabetic foot have a significant impact on mortality.
本研究旨在评估影响 1 年和 5 年死亡率的因素，并比较伴有合并症的糖尿病患者的大截肢和小截肢。
回顾性分析 2008 年 2 月至 2014 年 11 月期间 201 例 2 型糖尿病足患者（男 147 例，女 54 例；中位年龄：65.99 岁；范围 50 至 92 岁）的截肢手术。根据初始截肢水平将患者分为两组：组 1（n=100）为小截肢组，包括踝关节远端区域，组 2（n=101）为大截肢组，包括经胫骨截肢、经股骨截肢和髋关节离断。记录患者的人口统计学特征、再截肢程度、住院时间、高压氧治疗、合并症、血液参数和生存率等临床数据。
对 1 年死亡率的回归分析发现，存在脑血管疾病使死亡率增加 2.463 倍（p=0.002）。小截肢使死亡率增加 2.284 倍（p=0.006），患者年龄每增加 1 单位，死亡率增加 1.05 倍（p=0.008）。慢性肾功能衰竭使 5 年死亡率的回归分析中死亡率增加 3.164 倍（p<0.001）。
小截肢对 1 年死亡率有影响，脑血管疾病和年龄也是如此。另一方面，慢性肾功能衰竭对 5 年死亡率有负面影响。小截肢可能会对死亡率产生不利影响，因为糖尿病足病的持续进展和合并症的存在。与糖尿病足截肢相关的合并症对死亡率有重大影响。
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