Bonanni Federico Rolando, Meloni Marco, Salvi Martina, Bellizzi Ermanno, Ruotolo Valeria, Andreadi Aikaterini, Bellia Alfonso, Lauro Davide
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Division of Endocrinology and Diabetology, Department of Medical Sciences, University Hospital Fondazione Policlinico Tor Vergata, Rome, Italy.
Int J Low Extrem Wounds. 2025 Mar 28:15347346251328724. doi: 10.1177/15347346251328724.
The current study aimed to evaluate characteristics and outcomes of patients admitted for a diabetic foot attack (DFA). It is a retrospective observational study including a population of patients admitted for diabetic foot ulcers (DFU) in a specialized diabetic foot service. Based on the type of hospital admission (emergency or elective), patients were divided into two groups: those with DFA and those without DFA (chronic diabetic foot, CDF). The DFA was considered in case of ischemia, infection and Charcot foot requiring urgent hospitalization. The following in-hospital outcomes were evaluated: minor and major amputation, number of surgical procedures, length of stay (LOS), mortality. Overall, 150 patients were included. The mean age was 70.3 ± 12.2 years, most patients were male (76.0%) and had type 2 diabetes (92.7%) with a mean duration of 22.1 ± 13.2 years; 88 (58.7%) patients presented DFA while 62 (41.3%) presented CDF. The DFA group reported a greater rate of foot infection (81.8 vs 50.0%, p = 0.002), higher HbA1c values (67.9 ± 22 vs 56.6 ± 14.3 mmol/mol, p = 0.0005) and more cases of first assessment for DFUs (43.2 vs 12.9%, p = 0.005) compared with the CDF group. Outcomes for DFA and CDF were minor amputation (36.4 vs 21%, p = 0.04), major amputation (2.3 vs 1.6%, p = 0.7), need for surgical procedures (>1) (27.3 vs 11.3%, p = 0.0001), LOS (17 ± 9.6 vs 12 ± 6.3 days, p = 0.0004), mortality (1.1 vs 0%, p = 0.6). In addition, foot infection and poor glycometabolic control were independently related to the DFA presentation. The DFA increases the risk of minor amputations, more surgical procedures and longer hospitalization. Foot infection and poor metabolic control resulted closely related to the DFA.
本研究旨在评估因糖尿病足发作（DFA）入院患者的特征及预后。这是一项回顾性观察研究，纳入了在专门的糖尿病足诊疗机构因糖尿病足溃疡（DFU）入院的患者群体。根据入院类型（急诊或择期），将患者分为两组：DFA患者和非DFA患者（慢性糖尿病足，CDF）。缺血、感染及需紧急住院治疗的夏科氏足情况被视为DFA。评估了以下住院结局：小截肢和大截肢、手术操作次数、住院时长（LOS）、死亡率。总共纳入了150例患者。平均年龄为70.3±12.2岁，大多数患者为男性（76.0%），患有2型糖尿病（92.7%），平均病程为22.1±13.2年；88例（58.7%）患者出现DFA，62例（41.3%）患者出现CDF。与CDF组相比，DFA组报告的足部感染率更高（81.8%对50.0%，p = 0.002）、糖化血红蛋白（HbA1c）值更高（67.9±22对56.6±14.3 mmol/mol，p = 0.0005）以及首次评估DFU的病例更多（43.2%对12.9%，p = 0.005）。DFA和CDF的结局为小截肢（36.4%对21%，p = 0.04）、大截肢（2.3%对1.6%，p = 0.7）、需要进行多次（>1次）手术操作（27.3%对11.3%，p = 0.0001）、LOS（17±9.6天对12±6.3天，p = 0.0004）、死亡率（1.1%对0%，p = 0.6）。此外，足部感染和血糖代谢控制不佳与DFA表现独立相关。DFA增加了小截肢、更多手术操作和更长住院时间的风险。足部感染和代谢控制不佳与DFA密切相关。
