Interdisciplinary treatment of diabetic foot wounds in the elderly: Low risk of amputations and mortality and good chance of being mobile with good quality of life
Interdisciplinary treatment of diabetic foot wounds in the elderly: Low risk of amputations and mortality and good chance of being mobile with good quality of life
复制标题
DOI：
10.1177/1479164116666477
复制
发表时间：
2017-01-01
影响因子：
2.4
通讯作者：
Beckh, Karlheinz
中科院分区：
文献类型：
--
作者：
Hartmann, Bettina;Fottner, Christian;Beckh, Karlheinz
目的：糖尿病足综合征的主要患者年龄在65岁以上。方法：在一项为期6个月的单中心观察性研究中，我们分析了245例患者的合并症和预后。结果：122例患者的外周动脉疾病随着年龄的增长而显著增加(n=245，df=1，(2)=23.06，p0.0001)。年龄增加与血管再造率下降呈正相关(n=12 2，df=1，(2)=4.2 3，p=0.039)。总共有23例(9.3%)患者在观察期内死亡。住院死亡率为2.8%，大截肢率为2.8%。在侵袭性治疗的亚组中，67名患者中有13名在观察期内死亡。血运重建后死亡与年龄无关(n=67，df=1，(2)=2.05，p=0.153)。随着年龄的增长，整个研究组的活动能力都有所下降。结论：通过仔细的跨学科评估，老年糖尿病足综合征患者可以获得良好的治疗效果。作为治疗成功和结果参数的预测指标，治疗前后的活动能力值得更多地关注。
Aims: A major proportion of patients with diabetic foot syndrome are older than 65years. Little is known about outcomes of these elderly patients.Methods: We analysed 245 treatment cases in an observational single-centre study for comorbidities and outcomes over a 6-month period.Results: In all, 122 patients had peripheral arterial disease which was significantly increasing with age (n=245, df=1, (2)=23.06, p0.0001). Increasing age correlated positively with decreasing rate of revascularisations (n=122, df=1, (2)=4.23, p=0.039). In total, 23 (9.3%) patients died in the observation period. In-hospital mortality was 2.8%, percentage of major amputations 2.8%. In the invasively treated subgroup, 13 out of 67 patients died within the observation period. Death after revascularisation was independent of age (n=67, df=1, (2)=2.05, p=0.153). Mobility decreased in the whole study group with increasing age. The risk of decrease with age was not influenced by revascularisation status.Conclusion: With careful interdisciplinary evaluation, elderly patients with diabetic foot syndrome can be treated with favourable outcome. Mobility before and after treatment deserves more attention as a predictor of treatment success and outcome parameter.