Shats V, Kozacov S
Geriatric Dept., Rebecca Sieff Government Hospital, Safed.
Harefuah. 1996 Dec 1;131(11):485-6, 535.
Among patients hospitalized in 1983-1992 were 416 (239 women) who were immobilized for at least 2 hours due to stroke, orthopedic surgery, or sepsis. 128 (30.8%) had pressure ulcers (PU); 100 (31.2%) had diabetes (DM), including 12 with IDDM and 118 with NIDDM; age (mean +/- SD) was 74.3 +/- 9.5 years. Those with IDDM and NIDDM were younger (70.9 +/- 10.5 and 71.5 +/- 8.4 years, respectively) than the nondiabetic (75.7 +/- 9.6 years; p > 0.05 and < 0.001, respectively). Those with PU were older (76.6 +/- 9.0 vs 73.3 +/- 9.6 years, p < 0.01). Incidence of PU in patients without DM was similar to that in those with NIDDM (30.4 vs 27.1%; no difference even after age-adjustment). However, incidence of PU was significantly higher in those with IDDM than in those without DM (75.0 vs 30.4%, p < 0.01). According to Medline (last 2 years screened), and EBSCO Physician Medline Plus (last 5 years screened), only 5 publications referred to DM as a risk factor for PU. According to our data NIDDM does not appear to be a risk factor for PU, but a causative role for IDDM deserves further study. Increased risk of diabetic foot, infections in ulcers and wounds, and slow healing in DM do not justify considering NIDDM a risk factor for PU.
在1983年至1992年住院的患者中，有416例（239名女性）因中风、骨科手术或败血症而至少固定不动2小时。128例（30.8%）有压疮（PU）；100例（31.2%）患有糖尿病（DM），其中12例为胰岛素依赖型糖尿病（IDDM），118例为非胰岛素依赖型糖尿病（NIDDM）；年龄（均值±标准差）为74.3±9.5岁。IDDM和NIDDM患者比非糖尿病患者年轻（分别为70.9±10.5岁和71.5±8.4岁）（非糖尿病患者为75.7±9.6岁；p值分别>0.05和<0.001）。有PU的患者年龄更大（76.6±9.0岁对73.3±9.6岁，p<0.01）。无DM患者的PU发生率与NIDDM患者相似（30.4%对27.1%；即使在年龄调整后也无差异）。然而，IDDM患者的PU发生率显著高于无DM患者（75.0%对30.4%，p<0.01）。根据医学在线数据库（筛选了最近2年）和EBSCO医师医学在线升级版（筛选了最近5年），只有5篇出版物将DM视为PU的危险因素。根据我们的数据，NIDDM似乎不是PU的危险因素，但IDDM的致病作用值得进一步研究。糖尿病足风险增加、溃疡和伤口感染以及DM中愈合缓慢并不能证明将NIDDM视为PU的危险因素是合理的。
