Department of Internal Medicine-Geriatric Medicine, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain.
Faculty of Health Sciences, Universidad Europea de Canarias, 38300 La Orotava, Spain.
Nutrients. 2023 Aug 24;15(17):3710. doi: 10.3390/nu15173710.
Sarcopenia and malnutrition have been associated in the elderly population with a poor prognosis in wound healing and with other adverse events, such as institutionalization or functional impairment. However, it is not known how these factors influence the prognosis of diabetic foot in the elderly. To answer this question, a prospective observational study of 45 patients over 65 years of age admitted with diagnoses of diabetic foot in a tertiary hospital has been conducted. All patients were assessed at admission and at 3 months after returning home to determine quality of life, pain, mobility and healing, overall hospital stay in relation to the presence of malnutrition (measured by BMI, CIPA scale and analytical parameters at admission of serum proteins and albumin), and sarcopenia measured by grip force, among other geriatric syndromes. The results found a relationship between altered sarcopenia and more pain and poorer quality of life, and altered BMI was related to a lower cure rate and worse mobility at follow-up. This study seems to indicate that, in the elderly population with diabetic foot, malnutrition and sarcopenia should be managed at the same time as the treatment of the diabetic foot itself.
肌肉减少症和营养不良与老年人的伤口愈合不良以及其他不良事件(如住院或功能障碍)相关。然而,目前尚不清楚这些因素如何影响老年人糖尿病足的预后。为了回答这个问题,对在一家三级医院就诊的 45 名 65 岁以上患有糖尿病足的患者进行了前瞻性观察研究。所有患者在入院时和出院后 3 个月进行评估,以确定生活质量、疼痛、活动能力和愈合情况,以及与营养不良(通过 BMI、CIPA 量表和入院时血清蛋白和白蛋白的分析参数来衡量)相关的总住院时间,以及通过握力等老年综合征来评估肌肉减少症。研究结果发现,肌肉减少症的改变与更多的疼痛和较差的生活质量有关,而 BMI 的改变与较低的治愈率和随访时较差的活动能力有关。这项研究似乎表明,在患有糖尿病足的老年人群中,应该在治疗糖尿病足本身的同时治疗营养不良和肌肉减少症。