دورية أكاديمية
Morbidity and mortality of infected diabetic foot managed in general surgical department.
| العنوان: | Morbidity and mortality of infected diabetic foot managed in general surgical department. |
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| المؤلفون: | Gouta EL, Khalfallah M, Dougaz W, Samaali I, Nouira R, Bouasker I, Dziri C |
| المصدر: | La Tunisie medicale [Tunis Med] 2018 Dec; Vol. 96 (12), pp. 875-883. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Societe Tunisienne Des Sciences Medicales Country of Publication: Tunisia NLM ID: 0413766 Publication Model: Print Cited Medium: Internet ISSN: 2724-7031 (Electronic) Linking ISSN: 00414131 NLM ISO Abbreviation: Tunis Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Tunis : Societe Tunisienne Des Sciences Medicales |
| مواضيع طبية MeSH: | Surgical Procedures, Operative*/methods , Surgical Procedures, Operative*/mortality , Surgical Procedures, Operative*/statistics & numerical data, Diabetic Foot/*epidemiology , Diabetic Foot/*surgery , Wound Infection/*epidemiology , Wound Infection/*surgery, Aged ; Amputation, Surgical/mortality ; Amputation, Surgical/statistics & numerical data ; Debridement/mortality ; Debridement/statistics & numerical data ; Diabetic Foot/complications ; Diabetic Foot/mortality ; Female ; Heart Failure/epidemiology ; Heart Failure/mortality ; Hospital Departments ; Hospital Mortality ; Humans ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Morbidity ; Mortality ; Multiple Organ Failure/epidemiology ; Multiple Organ Failure/mortality ; Retrospective Studies ; Tunisia/epidemiology ; Wound Infection/complications ; Wound Infection/mortality |
| مستخلص: | Background: Foot ulcers are diabetes-related complications which occur in 10%-25% in diabetic patients. They are an important cause of morbidity and mortality in diabetes. This retrospective study aimed to assess, using an administrative database, the morbidity and the mortality risk of infected diabetic ulcers. Methods: It's a retrospective study enrolling 644 patients operated on for a diabetic foot between January 1st, 2012 and December 31st, 2016 in the surgical department B of Charles Nicolle's Hospital. Logistic regression identified independent predictive factors of major amputation, morbidity and mortality. Results: This retrospective study showed that "Cardiac failure" (OR=5.00, 95%CI [1.08 23.25], p=0.039), "Admission in the ICU in the first 48h" (OR=12.76, 95%CI [4.92 33.33], p<0.001) and "Major amputation" (OR=6.40, 95%CI [2.41 16.94], p<0.001) were considered as independent predictive factors of mortality. As concerns morbidity, Cardiac failure (OR=0.163, 95%CI [0.055 0.479], p=0.001) and organ failure at admission (OR=0.017, 95%CI [0.004 0.066], p=0.017) were predictive factors of admission in the ICU during the first 48 hours. Besides, advanced age (OR=1.033, 95%CI [1.014 1.052], p=0.001), Pre-operative stay (OR=1.093, 95%CI [1.039 1.151], p=0.001) and admission in the ICU during the first 48 hours (OR=0.142, 95%CI [0.071 0.285], p<0.001) were predictive factors of major amputation. Moreover, Cardiac failure (OR=0.517, 95%CI [0.298 0.896], p=0.019), admission in the ICU during the first 48 hours (OR=0.176, 95%CI [0.088 0.354], p<0.001) and Pre-operative stay (OR=1.083, 95%CI [1.033 1.134], p=0.001) were predictive variables of complicated post-operative course. Admission in the ICU during the first 48h (OR=0.140, 95%CI [0.48 0.405], p<0.001), major amputation (OR=0.170, 95%CI [0.76 0.379], p<0.001), and number of ICU stays (OR=3.341, 95%CI [1.558 7.164], p=0.002) were predictive factors of medical complications. Preoperative stay (OR=1.091, 95%CI [1.038 1.147], p=0.001) was predictive of reintervention. Conclusions: Our retrospective study assessed that mortality rate was inferior when the patient didn't have amputation, no post-operative complications and no reintervention. The main limitation of our study was the retrospective design. |
| تواريخ الأحداث: | Date Created: 20190528 Date Completed: 20190926 Latest Revision: 20221207 |
| رمز التحديث: | 20231215 |
| PMID: | 31131868 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2724-7031 |
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