Department of Dermatology, Yanbian University Hospital, Jilin, China.
Department of Medical Cosmetology, Yanbian University Hospital, Jilin, China.
Int Wound J. 2024 Jul;21(7):e14931. doi: 10.1111/iwj.14931.
This study analysed the incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers. This study systematically searched both Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, EMBASE and Web of Science, to identify cohort studies related to lower extremity amputation and associated risk factors in patients with diabetic foot ulcers up to October 2023. The patients were stratified based on whether they underwent lower extremity amputation, and relevant data, including basic information, patient characteristics, complications, comorbidities and pertinent laboratory test data, were extracted from the included studies. The literature quality assessment in this study utilized the Newcastle-Ottawa Scale to screen for high-quality literature, resulting in the inclusion of 16 cohort studies, all of which were of at least moderate quality. Meta-analysis of outcome indicators was conducted using the Stata 14.0 software. The results indicate that the overall amputation rate of lower extremities in patients with diabetic foot ulcers is 31% (0.25, 0.38). Among the 16 variables evaluated, gender (male), smoking history, body mass index (BMI), hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels were found to be correlated with the occurrence of lower extremity amputation in patients with diabetic foot ulcers. However, no significant correlation was observed between age, diabetes type, duration of diabetes, stroke, glycosylated haemoglobin, creatinine and total cholesterol levels and lower extremity amputation in patients with diabetic foot ulcers. This meta-analysis indicates that the overall amputation rate in patients with diabetic foot ulcers is 31%. Factors such as gender (male), smoking history, high BMI, hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels are identified as significant risk factors for lower extremity amputation in diabetic foot ulcer patients. These findings suggest that attention should be focused on these risk factors in patients with diabetic foot ulcers to reduce the risk of lower extremity amputation. Therefore, preventive and intervention measures targeting these risk factors are of significant importance in clinical practice. (Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024497538]).
本研究分析了糖尿病足溃疡患者下肢截肢的发生率及其相关危险因素。本研究系统地检索了中文和英文数据库，包括中国知网、万方、维普、PubMed、EMBASE 和 Web of Science，以确定截至 2023 年 10 月与糖尿病足溃疡患者下肢截肢及其相关危险因素相关的队列研究。根据是否进行了下肢截肢，将患者分为两组，并从纳入的研究中提取相关数据，包括基本信息、患者特征、并发症、合并症和相关实验室检查数据。本研究采用纽卡斯尔-渥太华量表对文献质量进行评估，筛选出高质量文献，共纳入 16 项队列研究，均为至少中等质量。使用 Stata 14.0 软件对结局指标进行荟萃分析。结果表明，糖尿病足溃疡患者下肢截肢的总体截肢率为 31%（0.25，0.38）。在评估的 16 个变量中，性别（男性）、吸烟史、体重指数（BMI）、高血压、心血管疾病、肾脏疾病、白细胞计数、血红蛋白和白蛋白水平与糖尿病足溃疡患者下肢截肢的发生相关。然而，年龄、糖尿病类型、糖尿病病程、中风、糖化血红蛋白、肌酐和总胆固醇水平与糖尿病足溃疡患者下肢截肢之间无显著相关性。本荟萃分析表明，糖尿病足溃疡患者的总体截肢率为 31%。性别（男性）、吸烟史、高 BMI、高血压、心血管疾病、肾脏疾病、白细胞计数、血红蛋白和白蛋白水平等因素被确定为糖尿病足溃疡患者下肢截肢的显著危险因素。这些发现表明，应关注糖尿病足溃疡患者的这些危险因素，以降低下肢截肢的风险。因此，针对这些危险因素采取预防和干预措施在临床实践中具有重要意义。（系统评价注册：https://www.crd.york.ac.uk/PROSPERO/，标识符[CRD42024497538]）。
