Clinical features and risk factors of diabetic foot_West China Medical Journal

Authors：

WANG Yanhong ,  YUE Zongxiang , HUANG Rongli , YANG Ruoyu , LIU Zhiqin , GUO Qin , HE Yuequn

Department of Endocrinology, Meishan Hospital of Traditional Chinese Medicine, Meishan, Sichuan 620010, P. R. China;

Corresponding?author：

YUE Zongxiang, Email: 394956389@qq.com

Keywords：

Diabetic foot; Clinical features; Risk factors; Amputation; Retrospective analysis

DOI：

10.7507/1002-0179.201605128

Video：

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Objective To investigate the clinical features and risk factors of diabetic foot. Methods A total of 100 patients with diabetic foot and 158 diabetic patients without diabetic foot were selected from April 2012 to May 2015 in Meishan Hospital of Traditional Chinese Medicine. Clinical data of the patients in the two groups was comparatively analyzed. Multiple logistic regression analysis was used to explore the risk factors. Results The age, duration of diabetes, incidences of complications, count of white blood cells, level of fibrinogen, level of high-sensitivity C-reactive protein (hs-CRP) and level of glycated hemoglobin (HbA1c) in diabetic foot group were significantly higher than those in non-diabetic foot group (P<0.05), while the ankle-brachial index, level of hemoglobin and level of albumin in diabetic foot group were significantly lower than those in non-diabetic foot group (P<0.05). The independent risk factors of diabetic foot were Wanger grade, age, ankle-brachial index, hs-CRP, albumin and HbA1c (P<0.05). HbA1c and hs-CRP level were independent risk factors of disease severity in patients with diabetic foot; the difference of prognosis in patients with different Wanger grading was statistically significant (Z=–4.394, P<0.001). Conclusions The risk of diabetic foot in diabetic patients increases with older age, the more serious Wanger grade, the higher hs-CRP and HbA1c level, and the lower ankle-brachial index and albumin level. Taking precautions based on the patient’s situation is conducive to early prevention of amputation in diabetic patients with diabetic foot.

Citation： WANG Yanhong, YUE Zongxiang, HUANG Rongli, YANG Ruoyu, LIU Zhiqin, GUO Qin, HE Yuequn. Clinical features and risk factors of diabetic foot. West China Medical Journal, 2017, 32(8): 1199-1202. doi: 10.7507/1002-0179.201605128 Copy

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2.	Uccioli L, Izzo V, Meloni M, et al. Non-healing foot ulcers in diabetic patients: general and local interfering conditions and management options with advanced wound dressings. J Wound Care, 2015, 24(4 Suppl): 35-42.
3.	許蕾, 錢鴻潔, 張杉杉, 等. 不同程度感染的糖尿病足潰瘍患者臨床特點及預后分析. 中華內分泌代謝雜志, 2013, 29(2): 116-119.
4.	費揚帆, 王椿, 陳大偉, 等. 住院糖尿病足患者截肢率與截肢危險因素分析. 中華醫學雜志, 2012, 92(24): 1686-1689.
5.	Pickwell K, Siersma V, Kars M, et al. Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer. Diabetes Care, 2015, 38(5): 852-857.
6.	Assaad-Khalil SH, Zaki A, Abdel Rehim A, et al. Prevalence of diabetic foot disorders and related risk factors among Egyptian subjects with diabetes. Prim Care Diabetes, 2015, 9(4): 297-303.
7.	Jiang Y, Ran X, Jia L, et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China. Int J Low Extrem Wounds, 2015, 14(1): 19-27.
8.	錢榮立. 關于糖尿病的新診斷標準與分型. 中國糖尿病雜志, 2000, 8(1): 5-6.
9.	Bader MS, Alavi A. Management of hospitalized patients with diabetic foot infections. Hosp Pract, 2014, 42(4): 111-125.
10.	Calderini C, Cioni F, Haddoub S, et al. Therapeutic approach to "diabetic foot" complications. Acta Biomed, 2014, 85(3): 189-204.
11.	趙若楠, 韓桂艷, 倪冬梅. 糖尿病足壞疽相關危險因素分析. 中華損傷與修復雜志: 電子版, 2012, 7(2): 26-29.
12.	沈艷軍, 畢會民. 糖尿病足發生發展的危險因素. 中國老年學雜志, 2012, 32(6): 1153-1156.
13.	趙靜靜, 王偉靈, 鄭培莉. 中國人群糖尿病足相關危險因素的 Meta 分析. 檢驗醫學, 2014(6): 640-645.
14.	楊群英, 薛耀明, 曹瑛, 等. 糖尿病足潰瘍的臨床特點及危險因素分析. 中國糖尿病雜志, 2012, 20(3): 189-191.
15.	李永恒, 何利平, 王椿, 等. 糖尿病足危險因素分析. 中華糖尿病雜志, 2012, 4(3): 155-158.
16.	張凈, 薛耀明. 2 型糖尿病踝肱指數異常相關危險因素分析及對糖尿病足的預測價值. 中華內科雜志, 2013, 52(11): 951-955.
17.	詹海娃. 老年糖尿病患者糖尿病足發病的相關因素分析. 中華現代護理雜志, 2014, 20(10): 1125-1127.
18.	李惠琴, 蘇曉飛, 丁波, 等. 218 例糖尿病足患者臨床特征及高危因素分析. 中華內分泌代謝雜志, 2012, 28(6): 492-495.
19.	李饒, 袁麗, 郭曉蕙, 等. 中國 2 型糖尿病患者足部護理知識和足部自我護理行為現狀及影響因素的研究. 中華護理雜志, 2014, 49(8): 909-913.
20.	陸晴, 王娜, 許紅. 國內糖尿病足護理的研究進展與前沿分析. 中華現代護理雜志, 2013, 48(33): 4179-4182.

1. Lew EJ, Mills JL, Armstrong DG. The deteriorating DFU: prioritising risk factors to avoid amputation. J Wound Care, 2015, 24(5 Suppl 2): 31-37.
2. Uccioli L, Izzo V, Meloni M, et al. Non-healing foot ulcers in diabetic patients: general and local interfering conditions and management options with advanced wound dressings. J Wound Care, 2015, 24(4 Suppl): 35-42.
3. 許蕾, 錢鴻潔, 張杉杉, 等. 不同程度感染的糖尿病足潰瘍患者臨床特點及預后分析. 中華內分泌代謝雜志, 2013, 29(2): 116-119.
4. 費揚帆, 王椿, 陳大偉, 等. 住院糖尿病足患者截肢率與截肢危險因素分析. 中華醫學雜志, 2012, 92(24): 1686-1689.
5. Pickwell K, Siersma V, Kars M, et al. Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer. Diabetes Care, 2015, 38(5): 852-857.
6. Assaad-Khalil SH, Zaki A, Abdel Rehim A, et al. Prevalence of diabetic foot disorders and related risk factors among Egyptian subjects with diabetes. Prim Care Diabetes, 2015, 9(4): 297-303.
7. Jiang Y, Ran X, Jia L, et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China. Int J Low Extrem Wounds, 2015, 14(1): 19-27.
8. 錢榮立. 關于糖尿病的新診斷標準與分型. 中國糖尿病雜志, 2000, 8(1): 5-6.
9. Bader MS, Alavi A. Management of hospitalized patients with diabetic foot infections. Hosp Pract, 2014, 42(4): 111-125.
10. Calderini C, Cioni F, Haddoub S, et al. Therapeutic approach to "diabetic foot" complications. Acta Biomed, 2014, 85(3): 189-204.
11. 趙若楠, 韓桂艷, 倪冬梅. 糖尿病足壞疽相關危險因素分析. 中華損傷與修復雜志: 電子版, 2012, 7(2): 26-29.
12. 沈艷軍, 畢會民. 糖尿病足發生發展的危險因素. 中國老年學雜志, 2012, 32(6): 1153-1156.
13. 趙靜靜, 王偉靈, 鄭培莉. 中國人群糖尿病足相關危險因素的 Meta 分析. 檢驗醫學, 2014(6): 640-645.
14. 楊群英, 薛耀明, 曹瑛, 等. 糖尿病足潰瘍的臨床特點及危險因素分析. 中國糖尿病雜志, 2012, 20(3): 189-191.
15. 李永恒, 何利平, 王椿, 等. 糖尿病足危險因素分析. 中華糖尿病雜志, 2012, 4(3): 155-158.
16. 張凈, 薛耀明. 2 型糖尿病踝肱指數異常相關危險因素分析及對糖尿病足的預測價值. 中華內科雜志, 2013, 52(11): 951-955.
17. 詹海娃. 老年糖尿病患者糖尿病足發病的相關因素分析. 中華現代護理雜志, 2014, 20(10): 1125-1127.
18. 李惠琴, 蘇曉飛, 丁波, 等. 218 例糖尿病足患者臨床特征及高危因素分析. 中華內分泌代謝雜志, 2012, 28(6): 492-495.
19. 李饒, 袁麗, 郭曉蕙, 等. 中國 2 型糖尿病患者足部護理知識和足部自我護理行為現狀及影響因素的研究. 中華護理雜志, 2014, 49(8): 909-913.
20. 陸晴, 王娜, 許紅. 國內糖尿病足護理的研究進展與前沿分析. 中華現代護理雜志, 2013, 48(33): 4179-4182.

West China Medical Journal

Clinical features and risk factors of diabetic foot

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