Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Beijing Longfu Hospital, Beijing, China.
Orthop Surg. 2023 Dec;15(12):3272-3278. doi: 10.1111/os.13908. Epub 2023 Oct 10.
Chinese physicians developed the Tibial Transverse Transport (TTT) technique to treat diabetic foot ulcers with more than 90% effective rate. But this method still could not avoid the in-hospital death of patients. This study adopted a case-control study to explore the risk factors of in-hospital death in elderly patients with chronic ischemic diabetic foot after receiving TTT treatment.
A total of 54 patients were included in the study from January 1, 2017 to April 30, 2021, by being paired with the cases in case group with their demographic data and results of blood routine, liver and kidney function. There were nine patients in case group with six male and three male. Forty-five patients were selected in control group according to gender and diabetes type with 30 male and 15 female. Single factor logics regression analysis was used to explore the risk factors and odd ratios (OR) of in-hospital death in patients. The nomogram and decision curve analysis (DCA) had been done by R Studio software.
The study found that age, course of diabetic foot, small dense low-density Lipoprotein (smLDL), homocysteine (Hcy), superoxide dismutase (SOD), and prealbumin (PA) were risk factors for in-hospital death of patients. The smLDL had the highest risk. The nomogram showed that PA accounted for the largest proportion in the death risk factors. The results of DCA proved that above six risk factors were the risk factors for patients with TEXAS Stage 3 and 4 diabetic foot ulcers.
In the future diagnosis and TTT treatment for diabetic foot ulcers, doctors need to pay close attention to age, course of diabetic foot, smLDL, Hcy, SOD, and PA.
中国医生开发了胫骨横向迁移（TTT）技术，以 90%以上的有效率治疗糖尿病足溃疡。但这种方法仍无法避免患者的院内死亡。本研究采用病例对照研究，探讨 TTT 治疗后老年慢性缺血性糖尿病足患者院内死亡的危险因素。
2017 年 1 月 1 日至 2021 年 4 月 30 日，通过与病例组患者的人口统计学数据和血常规、肝肾功能结果进行配对，本研究共纳入 54 例患者。在病例组中，有 9 例患者，其中 6 例为男性，3 例为女性。根据性别和糖尿病类型，在对照组中选择了 45 例患者，其中 30 例为男性，15 例为女性。采用单因素逻辑回归分析探讨患者院内死亡的危险因素和比值比（OR）。采用 R Studio 软件进行列线图和决策曲线分析（DCA）。
研究发现，年龄、糖尿病足病程、小而密低密度脂蛋白（smLDL）、同型半胱氨酸（Hcy）、超氧化物歧化酶（SOD）和前白蛋白（PA）是患者院内死亡的危险因素。smLDL 具有最高的风险。列线图显示，PA 在死亡危险因素中占比最大。DCA 结果证明，上述 6 个危险因素是 TEXAS 分期 3 和 4 糖尿病足溃疡患者的危险因素。
在未来对糖尿病足溃疡的诊断和 TTT 治疗中，医生需要密切关注年龄、糖尿病足病程、smLDL、Hcy、SOD 和 PA。
