ABSTRACT

Background

Limited scientific evidence for prevention and treatment of diabetic foot ulcers in elderly with comorbidities.

Aim

To explore patient-related factors and outcomes in patients ≥75 years with diabetes and a foot ulcer.

Method

Sub-analysis of consecutively presenting patients ≥75 years (N = 1008) from a previous study on 2,480 patients with diabetic foot ulcer treated in a multidisciplinary system until healing. Patient characteristics: age – 81(75–96); diabetes type 2–98.7%; male/female – 49/51%; living with a spouse – 47%; nursing home 16%; or with home nursing 64%.

Result

Primary healing was achieved in 54%, minor amputation 8%, major amputation 9%, auto-amputation 2%, and 26% of the patients died unhealed. Among the oldest (88–96 years), 31% healed without any amputation. Extensive comorbidities were frequent: neuropathy 93%, visual impairment 73%, cardiovascular disease 60%, cerebrovascular disease 34%, and severe peripheral disease in 29% of the patients. Out of patients (80%) living in institutions or dependent on home nursing, 56% healed without amputation, compared to 44% of patients living in their own home without any support from social services or home nursing.

Conclusion

Healing without major amputation was achieved in 84% of surviving patients ≥75 years, despite extensive comorbidity and dependency.

中文翻译：

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尽管有广泛的合并症和依赖性，患有糖尿病和足部溃疡的老年人仍有可能痊愈

摘要

背景

预防和治疗患有合并症的老年人糖尿病足溃疡的科学证据有限。

目标

探讨≥75 岁糖尿病足溃疡患者的相关因素和结局。

方法

对 2,480 名糖尿病足溃疡患者的先前研究中连续出现的≥75 岁患者（N = 1008）的亚分析，该患者在多学科系统中治疗直至痊愈。患者特征：年龄 - 81（75-96）；2型糖尿病–98.7%；男性/女性——49/51%；与配偶同住——47%；疗养院 16%；或家庭护理 64%。

结果

54% 的患者实现了初步愈合，8% 的小截肢，9% 的大截肢，2% 的自动截肢，26% 的患者在未愈合的情况下死亡。在年龄最大的（88-96 岁）中，31% 的人在没有截肢的情况下痊愈。广泛的合并症很常见：93% 的患者出现神经病变，73% 的视力障碍，60% 的心血管疾病，34% 的脑血管疾病和 29% 的严重外周疾病。在生活在机构或依赖家庭护理的患者中（80%），56% 的患者在没有截肢的情况下痊愈，而在没有任何社会服务或家庭护理支持的情况下住在自己家中的患者中，这一比例为 44%。

结论

尽管存在广泛的合并症和依赖性，但 84% 的 ≥75 岁存活患者实现了无需大截肢的治愈。