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.
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11.	赵若楠, 韩桂艳, 倪冬梅. 糖尿病足坏疽相关危险因素分析. 中华损伤与修复杂志: 电子版, 2012, 7(2): 26-29.
12.	沈艳军, 毕会民. 糖尿病足发生发展的危险因素. 中国老年学杂志, 2012, 32(6): 1153-1156.
13.	赵静静, 王伟灵, 郑培莉. 中国人群糖尿病足相关危险因素的 Meta 分析. 检验医学, 2014(6): 640-645.
14.	杨群英, 薛耀明, 曹瑛, 等. 糖尿病足溃疡的临床特点及危险因素分析. 中国糖尿病杂志, 2012, 20(3): 189-191.
15.	李永恒, 何利平, 王椿, 等. 糖尿病足危险因素分析. 中华糖尿病杂志, 2012, 4(3): 155-158.
16.	张净, 薛耀明. 2 型糖尿病踝肱指数异常相关危险因素分析及对糖尿病足的预测价值. 中华内科杂志, 2013, 52(11): 951-955.
17.	詹海娃. 老年糖尿病患者糖尿病足发病的相关因素分析. 中华现代护理杂志, 2014, 20(10): 1125-1127.
18.	李惠琴, 苏晓飞, 丁波, 等. 218 例糖尿病足患者临床特征及高危因素分析. 中华内分泌代谢杂志, 2012, 28(6): 492-495.
19.	李饶, 袁丽, 郭晓蕙, 等. 中国 2 型糖尿病患者足部护理知识和足部自我护理行为现状及影响因素的研究. 中华护理杂志, 2014, 49(8): 909-913.
20.	陆晴, 王娜, 许红. 国内糖尿病足护理的研究进展与前沿分析. 中华现代护理杂志, 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. 许蕾, 钱鸿洁, 张杉杉, 等. 不同程度感染的糖尿病足溃疡患者临床特点及预后分析. 中华内分泌代谢杂志, 2013, 29(2): 116-119.
4. 费扬帆, 王椿, 陈大伟, 等. 住院糖尿病足患者截肢率与截肢危险因素分析. 中华医学杂志, 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. 钱荣立. 关于糖尿病的新诊断标准与分型. 中国糖尿病杂志, 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. 赵若楠, 韩桂艳, 倪冬梅. 糖尿病足坏疽相关危险因素分析. 中华损伤与修复杂志: 电子版, 2012, 7(2): 26-29.
12. 沈艳军, 毕会民. 糖尿病足发生发展的危险因素. 中国老年学杂志, 2012, 32(6): 1153-1156.
13. 赵静静, 王伟灵, 郑培莉. 中国人群糖尿病足相关危险因素的 Meta 分析. 检验医学, 2014(6): 640-645.
14. 杨群英, 薛耀明, 曹瑛, 等. 糖尿病足溃疡的临床特点及危险因素分析. 中国糖尿病杂志, 2012, 20(3): 189-191.
15. 李永恒, 何利平, 王椿, 等. 糖尿病足危险因素分析. 中华糖尿病杂志, 2012, 4(3): 155-158.
16. 张净, 薛耀明. 2 型糖尿病踝肱指数异常相关危险因素分析及对糖尿病足的预测价值. 中华内科杂志, 2013, 52(11): 951-955.
17. 詹海娃. 老年糖尿病患者糖尿病足发病的相关因素分析. 中华现代护理杂志, 2014, 20(10): 1125-1127.
18. 李惠琴, 苏晓飞, 丁波, 等. 218 例糖尿病足患者临床特征及高危因素分析. 中华内分泌代谢杂志, 2012, 28(6): 492-495.
19. 李饶, 袁丽, 郭晓蕙, 等. 中国 2 型糖尿病患者足部护理知识和足部自我护理行为现状及影响因素的研究. 中华护理杂志, 2014, 49(8): 909-913.
20. 陆晴, 王娜, 许红. 国内糖尿病足护理的研究进展与前沿分析. 中华现代护理杂志, 2013, 48(33): 4179-4182.

West China Medical Journal

Clinical features and risk factors of diabetic foot

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