糖尿病足患者的死亡相关危险因素分析

Analysis of risk factors of morality in patients with diabetic foot

目的探讨并分析影响糖尿病足(DF)患者死亡的相关因素。方法选取2013年1月-2015年12月于阜阳市人民医院内分泌科住院的DF患者201例,电话随访3年,依据患者生存情况分为死亡组和存活组。分析两组一般资料、生化特征、病死率及死亡危险因素。结果死亡组糖尿病病程、DF病程及糖化血红蛋白(HbA1c)高于存活组(P <0.05),两组有无心脑血管病史和有无截趾比较,差异有统计学意义(P <0.05);DF患者的3年累计病死率为16.9%,Kaplan-Meier生存分析结果示糖尿病病程、DF病程、HbA1c、截趾及心脑血管病史均影响DF患者的生存率(P<0.05);多因素Cox回归分析显示,年龄[OR=1.052(95%CI:1.020,1.085)]、糖尿病病程[OR=1.094(95%CI:1.036,1.156)]、DF病程[OR=23.357(95%CI:5.752,94.853)]、HbA1c[OR=2.185(95%CI:1.549,3.082)]及心脑血管病史[OR=2.625(95%CI:1.265,5.448)]是影响DF患者死亡的危险因素。结论 DF患者的病死率受多种因素影响,与年龄、糖尿病病程、DF病程、HbA1c及心脑血管病史相关。

Objective To evaluate the risk factors for morality in patients with diabetic foot(DF). Methods A total of 201 hospitalized patients with diabetic foot in the Fuyang People’s Hospital from January 2013 to December 2015 were enrolled in this study and followed up for 3 year. The patients were divided into dead group and survival group, and the general data, bio-chemical datas, mortality and related risk factors were analyzed. Results The course of diabetes, the course of DF and HbA1 c in the dead group were higher than those in the survival group(P < 0.05);there are statistical differences in comparison of two groups with or without history of cardio or cerebral vascular disease and toe amputation(P < 0.05);the cumulative mortality of DF patients in three years was 16.9%. The results of Kaplan Meier survival analysis showed that the course of diabetes, the course of DF, HbA1 c, the course of toe amputation and the history of cardiovascular and cerebrovascular diseases all affected DF patients(P < 0.05). Multivariate Cox regression analysis showed that age [OR=1.052,(95% CI: 1.020, 1.085)], duration of diabetes [OR=1.094,(95% CI: 1.036, 1.156)], duration of DF [OR=23.357,(95% CI: 5.752, 94.853)], HbA1 c [OR=2.185,(95% CI: 1.549, 3.082)], and history of cardiovascular and cerebrovascular diseases [OR=2.625,(95% CI: 1.265, 5.448] were risk factors of DF patients’ morality. Conclusion The mortality of patients with DF is affected by many factors, which are related to age, course of diabetes, course of DF, HbA1 c and history of cardiovascular and cerebrovascular diseases.