Incidence, outcomes, and cost of foot ulcers in patients with diabetes
Incidence, outcomes, and cost of foot ulcers in patients with diabetes
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DOI：
10.2337/diacare.22.3.382
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发表时间：
1999-03-01
期刊：
影响因子：
16.2
通讯作者：
McCullough, DK
中科院分区：
文献类型：
--
作者：
Ramsey, SD;Sandhu, N;McCullough, DK
目的 - 确定大量糖尿病患者的脚溃疡的发生率，诊断后出现严重并发症的风险以及与没有足部溃疡的患者相比，可归因的护理成本。从1993年到1995年，大型员工模型健康维护组织中糖尿病的患者中有糖尿病患者。和药房记录。该数据用于计算足部溃疡的发生率，骨髓炎的风险，截肢和诊断为足球溃疡后死亡以及与没有足球溃疡的患者相比，足体溃疡患者的归因于造成的，在8,905例患者中，有8,905例患者在1型或类型的患者中。 2个糖尿病，514个糖尿病在3年的观察过程中出现了一个足球溃疡（累积发生率为5.8％）。在诊断后或之后，有77名（15％）患者患有骨髓炎和80例（15.6％）所需的截肢。一组没有足部溃疡的年龄和性别匹配的糖尿病患者，足球溃疡患者维纳斯（Venus）的3岁生存率为72％（p <0.001）。诊断后的两年中，一名40至65岁男性患有40至65岁男性的成本为27,987美元。结论 - 这一糖尿病患者队列中的脚溃疡的发生率接近每年2.0％。对于那些患有溃疡，发病率，死亡率和过度护理费用的人，与没有足球溃疡的患者相比，那些患者相当大。该结果似乎支持针对糖尿病患者的预防足球预防计划的价值。
OBJECTIVE - To determine the incidence of foot ulcers in a large cohort of patients with diabetes, the risk of developing serious complications after diagnosis, and the attributable cost of care compared with that in patients without foot ulcers.RESEARCH DESIGN AND METHODS - Retrospective cohort study of patients with diabetes in a large staff-model health maintenance organization from 1993 to 1995. Patients with diabetes were identified by algorithm using administrative, laboratory and pharmacy records. The data were used to calculate incidence of foot ulcers, risk of osteomyelitis, amputation, and death after diagnosis of foot ulcer, and attributable costs in foot ulcer patients compared with patients without foot ulcers.RESULTS - Among 8,905 patients identified with type 1 or type 2 diabetes, 514 developed a foot ulcer over 3 years of observation (cumulative incidence 5.8%). On or after the time of diagnosis, 77 (15%) patients developed osteomyelitis and 80 (15.6%) required amputation. Survival at 3 years was 72% for the foot ulcer patients venus 87% for a group of age- and sex-matched diabetic patients without foot ulcers (P < 0.001). The attributable cost for a 40- to 65-year-old male with a new foot ulcer was $27,987 for the 2 years after diagnosis.CONCLUSIONS - The incidence of foot ulcers in this cohort of patients with diabetes was nearly 2.0% per year. For those who developed ulcers, morbidity, mortality, and excess care costs were substantial compared with those for patients without foot ulcers. The results appear to support the value of foot-ulcer prevention programs for patients with diabetes.