Heart failure in hospitalized patients with diabetic foot ulcers: Clinical characteristics and their relationship with prognosis (糖尿病足溃疡住院患者的心衰:临床特点以及它们与预后的关系)

Authors


Abstract

Background

In the present study we: (i) evaluated the incidence of heart failure (HF) in patients with diabetic foot ulcer (DFU); and (ii) investigated the relationship between the clinical characteristics in these patients and prognosis.

Methods

The clinical characteristics of 330 consecutive Chinese patients (137 men, 193 women) hospitalized for DFU were collected and assessed to determine the effects of HF on DFU. All patients were followed for 3 months and rates of healing, the development of new ulcers, amputations, and mortality were calculated at the end of the follow-up period.

Results

Heart failure was present in 64.3% of patients with DFU, with the prevalence of HF increasing with Wagner grade from Wagner 1 through to Wagner 5 (42.4%, 59.1%, 64.7%, 73.3%, and 87.0%, respectively), higher than the 33.6% prevalence in diabetic patients without DFU (Wagner 0). The presence of HF conferred a greater increased relative risk of a worse prognosis. The 3-month healing rates of DFU in patients with and without HF were 60.3% and 75.7%, respectively. Recurrence (13.2% vs 7.5%) and amputations (28.6% vs 20.0%) were more frequent in patients with than without HF (P < 0.05). All-cause mortality was recorded for 14 of 126 patients with HF compared with three of 70 patients without HF (11.1% vs 4.3%, respectively; P < 0.05).

Conclusions

The prevalence of HF is high in Chinese inpatients with DFU, with the presence of HF indicating a worse prognosis for these patients.

摘要

背景

分析糖尿病足溃疡患者的心衰发病率,探讨此类患者的临床特点与其预后的关系。

方法

收集330例(男137例,女193例)糖尿病足溃疡住院患者的资料,分析心衰对糖尿病足溃疡的影响。随访3个月,随访期结束时计算患者的溃疡治愈率、复发率、截肢率及死亡率。

结果

糖尿病足溃疡住院患者的总体心衰发病率为64.3%,且随溃疡严重程度增加(Wagner分级从Wagner 1 至Wagner 5级)而逐渐升高(分别为42.4%,59.1%,64.7%,73.3%,87.0%),显著高于无糖尿病足溃疡患者(Wagner 0级)的心衰发病率(33.6%)。合并心衰的足溃疡患者预后差的相对危险性增加。有无心衰的两组患者3个月的溃疡愈合率分别为60.3%和75.7%。合并心衰患者的足溃疡复发率、截肢率及死亡率均较对照组高(13.2% vs 7.5%,28.6% vs 20.0%,11.1% vs 4.3%,P均 < 0.05)。

结论

中国糖尿病足溃疡住院患者的心衰发病率较高,合并心衰的足溃疡患者预后较差。

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