Healing of diabetic neuropathic foot ulcers receiving standard treatment - A meta-analysis
Healing of diabetic neuropathic foot ulcers receiving standard treatment - A meta-analysis
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DOI：
10.2337/diacare.22.5.692
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发表时间：
1999-05-01
期刊：
影响因子：
16.2
通讯作者：
Berlin, JA
中科院分区：
文献类型：
--
作者：
Margolis, DJ;Kantor, J;Berlin, JA
目的-本研究的目的是确定接受良好的伤口护理的糖尿病神经性足溃疡的个人在一个定义的时间内愈合的百分比。研究设计和方法-我们进行了一项系统的审查对照组的临床试验，评估糖尿病神经性足溃疡的治疗。使用的荟萃分析技术包括估计终点愈合的加权平均百分比，评价试验的同质性，以及估计分组数据的95%CI。分组数据进行单变量和多变量logistic回归，以评估平均年龄，溃疡病，溃疡愈合的百分比在endpoint.RESULTS -我们发现，共有10个对照组符合我们的标准的影响，持续时间。6个对照组以20周作为愈合或不愈合的终点。在6个对照组中，20周的终点，我们发现加权平均愈合率为30.9%（95%CI 26.6-35.1）。对4个12周组进行的类似分析发现平均愈合率为24.2%（19.5-28.8）。我们未能检测到任何统计学显着的异质性无论是20周或12周的trials.CONCLUSIONS -经过20周的良好的伤口护理，类似于31%的糖尿病神经性溃疡愈合。同样，经过12周的良好护理，大约24%的神经性溃疡完全愈合。需要进一步的患者水平分析，以明确确定年龄、伤口大小和伤口持续时间与愈合可能性的相关性。
OBJECTIVE - The aim of the study was to determine the percentage of individuals with neuropathic diabetic foot ulcers receiving good wound care who heal within a defined period of time.RESEARCH DESIGN AND METHODS - We conducted a systematic review of the control groups of clinical trials that evaluated a treatment for diabetic neuropathic foot ulcers. The meta-analytic techniques used include an estimation of the weighted mean percentage healed by end point, an evaluation of the homogeneity of trials, and an estimate of the 95% CI of the grouped data. Grouped-data univariate and multivariate logistic regression was conducted to assess the impact of mean age, ulcer sire, and duration on the percentage of ulcers healed at end point.RESULTS - We found a total of 10 control groups meeting our criteria. Six control groups used 20 weeks as the end point for healing or nonhealing. Por the six control arms with a 20-week end point, we found a weighted mean healing rate of 30.9% (95% CI 26.6-35.1). A similar analysis for the four 12-week arms found a mean healing rate of 24.2% (19.5-28.8). We failed to detect any statistically significant heterogeneity for either the 20-week or the 12-week trials.CONCLUSIONS - After 20 weeks of good wound care, similar to 31% of diabetic neuropathic ulcers heal. Similarly, after 12 weeks of good care, similar to 24% of neuropathic ulcers attain complete healing. Further patient-level analyses are necessary to definitively determine the associations of age, wound size, and wound duration with likelihood of healing.