目的:确定澳大利亚糖尿病相关足部疾病(DFD)住院和截肢的发生率趋势。
方法:我们从2010年至2019年的澳大利亚糖尿病登记处纳入了70,766名1型糖尿病患者和1,087,706名2型糖尿病患者,并与医院入院数据库相关联。年龄调整后的发病率趋势总结为年度百分比变化(APC)。
结果:在1型糖尿病患者中,2010年至2019年,DFD住院总数从每1000人年20.8增加到30.5(APC:5.1%(95%CI:3.5,6.8)),包括溃疡增加(13.3%(2.9,24.7)),骨髓炎(5.6%(2.7,8.7)),外周动脉疾病(7.7%(3.7,11.9)),和神经病变(8.7%(5.5,12.0))。在2型糖尿病患者中,在2010年至2019年期间,DFD住院率从每千人年18.6例变为24.8例(APC:4.5%(3.6、5.4);2012-2019年),包括溃疡增加(8.7%(4.0,13.7)),蜂窝织炎(5.4%(3.7,7.0)),骨髓炎(6.7%(5.7,7.7)),和神经病变(6.9%(5.2,8.5))。1型截肢稳定,而2型截肢减少(-6.0%(-9.1,-2.7)。对糖尿病持续时间的调整减弱了大多数增加的幅度,但许多人仍然很重要。
结论:澳大利亚DFD住院率显著增加,主要是由溃疡和神经病,强调管理DFD对预防住院的重要性。
OBJECTIVE: To determine trends in the incidence of hospitalizations and amputations for diabetes-related foot disease (DFD) in Australia.
METHODS: We included 70,766 people with type 1, and 1,087,706 with type 2 diabetes from the Australian diabetes registry from 2010 to 2019, linked to hospital admissions databases. Trends in age-adjusted incidence were summarized as annual percent changes (APC).
RESULTS: In people with type 1 diabetes, total DFD hospitalizations increased from 20.8 to 30.5 per 1,000 person-years between 2010 and 2019 (APC: 5.1% (95% CI: 3.5, 6.8)), including increases for ulceration (13.3% (2.9, 24.7)), osteomyelitis (5.6% (2.7, 8.7)), peripheral arterial disease (7.7% (3.7, 11.9)), and neuropathy (8.7% (5.5, 12.0)). In people with type 2 diabetes, DFD hospitalizations changed from 18.6 to 24.8 per 1,000 person-years between 2010 and 2019 (APC: 4.5% (3.6, 5.4); 2012-2019), including increases for ulceration (8.7% (4.0, 13.7)), cellulitis (5.4% (3.7, 7.0)), osteomyelitis (6.7% (5.7, 7.7)), and neuropathy (6.9% (5.2, 8.5)). Amputations were stable in type 1, whereas in type 2, above knee amputations decreased (-6.0% (-9.1, -2.7). Adjustment for diabetes duration attenuated the magnitude of most increases, but many remained significant.
CONCLUSIONS: DFD hospitalizations increased markedly in Australia, mainly driven by ulceration and neuropathy, highlighting the importance of managing DFD to prevent hospitalizations.