背景:糖尿病足溃疡是一种主要的医学疾病,社会,和经济问题,也是导致住院的主要原因,发病率增加,和死亡率。尽管事件有所增加,关于发病率及其预测因素的数据缺乏。
目的:在埃塞俄比亚中部的糖尿病随访诊所中评估糖尿病患者糖尿病足溃疡的发生率和预测因素。
方法:回顾性随访研究设计。
方法:从2012年1月1日至2022年12月31日,共418例新诊断的糖尿病患者。使用计算机生成的简单随机抽样方法来选择研究参与者。使用结构化数据提取检查表收集数据。将收集的数据输入EpiInfoV.7.2,并输出到STATAV.14进行分析。为了估计生存时间,采用Kaplan-Meier法,生存差异用对数秩检验检验。
方法:拟合Cox比例风险模型以确定糖尿病足溃疡发展的预测因子。使用具有95%置信区间(CI)的调整后的风险比(AHR)来估计关联的强度,在p<0.05时宣布有统计学意义。
结果:糖尿病足溃疡的总发生率为每100人年观察1.51例(95%CI1.03至2.22)。10年内累积发生率为6.2%(95%CI4.1%至8.6%)。中位随访时间为45个月(IQR21~73)。舒张压为90mmHg或以上(AHR2.91,95%CI1.25至6.77),服用联合药物(AHR3.24,95%CI1.14~9.19)和患有外周动脉疾病(AHR5.26,95%CI1.61~17.18)是糖尿病足溃疡发展的统计学显著预测因子.
结论:糖尿病足溃疡的发生风险相对较高。舒张压水平,联合用药和外周动脉疾病是糖尿病足溃疡发展的独立预测因素.因此,密切监测和适当干预至关重要。
BACKGROUND: Diabetic foot ulcer is a major medical, social, and economic problem, and a leading cause of hospitalisations, increased morbidity, and mortality. Despite a rising occurrence, there is a dearth of data on the incidence and its predictors.
OBJECTIVE: To assess the incidence and predictors of diabetic foot ulcers among patients with diabetes mellitus in a diabetic follow-up clinic in Central Ethiopia.
METHODS: Retrospective follow-up
study design.
METHODS: A total of 418 newly diagnosed diabetes mellitus patients from 1 January 2012 to 31 December 2022. A computer-generated simple random sampling method was used to select the
study participants. Data were collected using a structured data extraction checklist. The collected data were entered into Epi Info V.7.2 and exported to STATA V.14 for analysis. To estimate survival time, the Kaplan-Meier method was used, and the survival difference was tested using a log-rank test.
METHODS: The Cox proportional hazard model was fitted to identify the predictors of diabetic foot ulcer development. The strength of the association was estimated using an adjusted hazard ratio (AHR) with a 95% confidence interval (CI), and statistical significance was proclaimed at a p<0.05.
RESULTS: The overall incidence of diabetic foot ulcer was 1.51 cases (95% CI 1.03 to 2.22) per 100 person-years of observation. The cumulative incidence was 6.2% (95% CI 4.1% to 8.6%) over 10 years. The median time of follow-up was 45 months (IQR 21-73). Diastolic blood pressure of 90 mm Hg or above (AHR 2.91, 95% CI 1.25 to 6.77), taking combined medication (AHR 3.24, 95% CI 1.14 to 9.19) and having a peripheral arterial disease (AHR 5.26, 95% CI 1.61 to 17.18) were statistically significant predictors of diabetic foot ulcer development.
CONCLUSIONS: The risk of occurrence of diabetic foot ulcer was relatively high. Diastolic blood pressure level, combined medication and peripheral arterial disease were independent predictors of diabetic foot ulcer development. Hence, close monitoring and proper interventions are essential.