Yıl: 2021 Cilt: 25 Sayı: 2 Sayfa Aralığı: 133 - 141 Metin Dili: İngilizce İndeks Tarihi: 29-11-2021

Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients

Öz:
Objective: To identify the clinical predictors of amputation outcomes inpatients with diabetic foot ulcers (DFUs) and the management of such pa-tients. Material and Methods: Four hundred (273 men; 127 women) pa- tients with DFUs, who were followed at our clinic between 2008-2014, were included. Patients' demographic characteristics, glycemic parameters, and diabetic complications were evaluated. The amputations were classified as minor (distal to metatarsus) and major (Chopart, and below or upper knee) amputations. Results: The mean age of the patients was 62.4±10.5 years.Three hundred and ninety-five patients had type 2 diabetes mellitus. The mean diabetes duration was 17±8 years. The rate of chronic diabetic com-plications consisting of neuropathy, nephropathy, and retinopathy were 97.5%, 81.3%, and 94.8%, respectively. Osteomyelitis and peripheral ar-terial disease rates were 327 (81.8%) and 265 (66%), respectively. The majority of the foot ulcers were of Wagner grade 3 (53.2%) and 4 (27.5%). According to the initial clinical considerations, 60% of the patients were administered empirical antibiotic therapy for infection. The minor and major amputation rates were 110 (25.5%) and 146 (36.3%), respectively. The average glycosylated hemoglobin value was 8.9±2.3%. Peripheral ar-terial disease [odds ratio (OR): 2.183, 95% confidence interval (CI): 1.242-3.837, p<0.001), osteomyelitis [OR: 5.062, 95% CI: 2.296-11.161, p<0.001) and Wagner grade (OR: 62.352, %95 CI: 7854-495.021, p<0.001) were found to increase the amputation risk. Conclusion: Dia- betic neuropathy is still an underlying major risk factor for the develop-ment of DFUs. The presence of peripheral arterial disease, osteomyelitis, and high Wagner degree are negative prognostic factors for the need for amputation.
Anahtar Kelime:

Diyabetes Mellitusun Yıkıcı Bir Komplikasyonu Olan Ayak Ülseri: 400 Hastadan Oluşan Tek Merkez Deneyimi

Öz:
Amaç: Diyabetik ayak ülseri ile amputasyon sonuçlarının, klinik belirleyi- cilerini ve hastaların yönetimini sunmaktır. Gereç ve Yöntemler: Çalış- maya, 2008 ve 2014 yılları arasında kliniğimizde izlenen diyabetik ayakülserli 400 (273 erkek, 127 kadın) hasta dâhil edildi. Hastaların demogra- fik özellikleri, glisemik parametreleri ve diyabetik komplikasyonları değer- lendirildi. Amputasyonlar, minör (metatarsın distalinde) ve majör (Chopartve diz altı veya diz üstü) amputasyonlar olarak sınıflandırıldı. Bulgular:Hastaların yaş ortalaması 62,4±10,5 yıl idi ve 395’i tip 2 diyabetes melli- tuslu idi. Ortalama diyabet süresi 17±8 yıl idi. Kronik diyabetik komplikas- yonlar olan nöropati, nefropati ve retinopati için oranlar sırasıyla %97,5;%81,3 ve %94,8 idi. Osteomiyelit ve periferik arteriyal hastalık oranları, sı- rasıyla 327 (%81,8) ve 265 (%66) saptandı. Ayak ülserlerinin çoğu, Wag- ner 3 (%53,2) ve 4 (%27,5) düzeyinde bulundu. İlk klinik değerlendirmeyegöre hastaların %60’ına enfeksiyon nedeniyle ampirik antibiyotik tedavisiverildi. Minör ve majör amputasyon oranları sırasıyla 110 (%25,5) ve 146(%36,3) idi. Hastaların ortalama glikozile hemoglobin düzeyi %8,9±2,3idi. Periferik arteriyal hastalık (olasılık oranı: 2,183; %95 güven aralığı:1,242-3,837; p<0,001), osteomiyelit (olasılık oranı: 5,062; %95 güvenaralığı: 2,296-11,161; p<0,001) ve Wagner derecesi (olasılık oranı:62,352; %95 güven aralığı: 7854-495,021; p<0,001), amputasyon riskiniartıran faktörler olarak bulundu. Sonuç: Diyabetik nöropati, diyabetik ayakülseri gelişimi için hâlâ temel risk faktörüdür. Periferik arteriyal hastalık,osteomiyelit ve yüksek Wagner derecesi varlığı, amputasyon ihtiyacı içinnegatif prognostik faktörlerdir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA EVRAN M, Sert M, Akkuş G, Bicer O, KESİKTAŞ E, KURTARA B, AKSUNGU E, TETİKER T (2021). Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. , 133 - 141.
Chicago EVRAN Mehtap,Sert Murat,Akkuş Gamze,Bicer Omer,KESİKTAŞ Erol,KURTARA Behice,AKSUNGU Erol,TETİKER Tamer Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. (2021): 133 - 141.
MLA EVRAN Mehtap,Sert Murat,Akkuş Gamze,Bicer Omer,KESİKTAŞ Erol,KURTARA Behice,AKSUNGU Erol,TETİKER Tamer Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. , 2021, ss.133 - 141.
AMA EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. . 2021; 133 - 141.
Vancouver EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. . 2021; 133 - 141.
IEEE EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T "Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients." , ss.133 - 141, 2021.
ISNAD EVRAN, Mehtap vd. "Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients". (2021), 133-141.
APA EVRAN M, Sert M, Akkuş G, Bicer O, KESİKTAŞ E, KURTARA B, AKSUNGU E, TETİKER T (2021). Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. Turkish Journal of Endocrinology and Metabolism, 25(2), 133 - 141.
Chicago EVRAN Mehtap,Sert Murat,Akkuş Gamze,Bicer Omer,KESİKTAŞ Erol,KURTARA Behice,AKSUNGU Erol,TETİKER Tamer Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. Turkish Journal of Endocrinology and Metabolism 25, no.2 (2021): 133 - 141.
MLA EVRAN Mehtap,Sert Murat,Akkuş Gamze,Bicer Omer,KESİKTAŞ Erol,KURTARA Behice,AKSUNGU Erol,TETİKER Tamer Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. Turkish Journal of Endocrinology and Metabolism, vol.25, no.2, 2021, ss.133 - 141.
AMA EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. Turkish Journal of Endocrinology and Metabolism. 2021; 25(2): 133 - 141.
Vancouver EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients. Turkish Journal of Endocrinology and Metabolism. 2021; 25(2): 133 - 141.
IEEE EVRAN M,Sert M,Akkuş G,Bicer O,KESİKTAŞ E,KURTARA B,AKSUNGU E,TETİKER T "Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients." Turkish Journal of Endocrinology and Metabolism, 25, ss.133 - 141, 2021.
ISNAD EVRAN, Mehtap vd. "Foot Ulcer a Devastating Complication ofDiabetes Mellitus:A Single-Center Experience of 400 Patients". Turkish Journal of Endocrinology and Metabolism 25/2 (2021), 133-141.