Leratong Hospital, Chamdor, Adcock Street, South Africa.
University of Pretoria, South Africa.
Surgeon. 2024 Apr;22(2):e109-e114. doi: 10.1016/j.surge.2023.11.009. Epub 2023 Dec 14.
Diabetes foot sepsis (DFS) is the leading cause of amputation of lower extremities. Over 50 % of patients who have had major lower extremity amputation due to DFS are dead within 4 years following the procedure.
To determine the life expectancy of patients following amputation for DFS at a regional hospital in South Africa.
We conducted an audit of patients who had DFS and were admitted over a 5-year period. The duration from admission to time of death was recorded in days. Occurrence of death was confirmed from family members of the deceased using structured telephonic interview questionnaires. Categorical findings were summarized using actual counts and percentages and compared using either the Chi-square or Fisher's exact test. We used the mean with standard deviation or median and range to compare parametric and non-parametric continuous data, respectively. The Shapiro-Wilk test was used to test normality of data. Multivariate logistic regression was done to establish factors that were strongly associated with the mortalities. Adjusted survival curves were added to compare the rate of occurrence of mortality between males and females with age as a confounder. Statistical significance was set at a p-value below 0.05.
197 were found of which 100 % of participants had Type 2 diabetes mellitus and 63.5 % were males. Associated comorbidities included hypertension in 73.6 %, obesity in 66 %, alcohol use in 64.5 % and smoking in 58.4 %. 190 participants had an amputation and 19.3 % died.
DFS was more common in males and 96 % of the patients had an amputation. Mortality rate within 4 years following amputation was 19.3 % and was higher in females and individuals with multiple comorbidities.
糖尿病足败血症（DFS）是下肢截肢的主要原因。超过 50%的因 DFS 而接受重大下肢截肢的患者在手术后 4 年内死亡。
确定南非一家地区医院因 DFS 截肢后患者的预期寿命。
我们对 5 年内因 DFS 入院的患者进行了审核。从入院到死亡的时间以天数记录。通过对死者家属进行结构化电话访谈问卷来确认死亡的发生。分类结果采用实际计数和百分比进行总结，并使用卡方或 Fisher 确切检验进行比较。我们使用均值加标准差或中位数和范围分别比较参数和非参数连续数据。Shapiro-Wilk 检验用于检验数据的正态性。使用多变量逻辑回归确定与死亡率密切相关的因素。添加调整后的生存曲线，以比较男性和女性在年龄作为混杂因素时的死亡率发生率。统计学意义设定为 p 值<0.05。
共发现 197 例，其中 100%的参与者患有 2 型糖尿病，63.5%为男性。相关合并症包括高血压 73.6%、肥胖 66%、饮酒 64.5%和吸烟 58.4%。190 名参与者进行了截肢，19.3%死亡。
DFS 在男性中更为常见，96%的患者进行了截肢。截肢后 4 年内的死亡率为 19.3%，女性和患有多种合并症的个体死亡率更高。
