Purpose

To explore the influencing factors of diabetic foot (DF) in diabetic patients and evaluate the influencing factors.

Methods

All 674 diabetic patients admitted to our hospital from January 2015 to June 2019 who met the research criteria were included as study subjects. Clinical data were collected retrospectively by filling in the case report form for clinical research, including the general demographic characteristics, disease history, laboratory examination results, and incidence of diabetes-related complications. Logistic regression analysis was used to screen the factors influencing DF: the nomogram method was applied to score the factors, and a scoring model was constructed.

Results

A total of 122 patients (18.1%) with newly diagnosed DF were identified. Multivariate analysis showed that long duration of diabetes (OR = 2.355), complicated diabetic nephropathy (OR = 3.073), and high HbA1c levels (OR = 1.885) were risk factors for DF development and that foot care education (OR = 0.473) was a protective factor. Cox proportional risk model analysis showed that, compared to patients with better control of HbA1C, the hazard ratio (HR) of DF in the HbA1 group, HbA2 group, and HbA3 group was 1.25, 1.58, and 4.71, respectively. Nomogram model analysis showed that the total score of each factor ranged from 44 to 176 points, and the corresponding risk rate ranged from 0.10 to 0.90 points. The higher the total score, the greater the risk of DF in diabetic patients; the area under the curve in the nomogram model was 0.742; 95% CI: 0.665~0.820 (P < 0.0001).

Conclusion

The key to preventing DF is to enhance diabetic patients’ education regarding DF care, improve patients’ self-management abilities, and improve patients’ blood glucose control.

中文翻译：

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糖尿病患者糖尿病足影响因素的列线图分析

目的

探讨糖尿病患者糖尿病足（DF）的影响因素并评价其影响因素。

方法

2015年1月至2019年6月我院收治的674例符合研究标准的糖尿病患者均作为研究对象。通过填写临床研究病例报告表回顾性收集临床资料，包括一般人口学特征、病史、实验室检查结果和糖尿病相关并发症的发生率。采用Logistic回归分析筛选影响DF的因素：采用列线图法对因素进行评分，构建评分模型。

结果

共确定了 122 名 (18.1%) 新诊断的 DF 患者。多变量分析显示，糖尿病病程长（OR = 2.355）、复杂性糖尿病肾病（OR = 3.073）和高 HbA1c 水平（OR = 1.885）是 DF 发展的危险因素，足部护理教育（OR = 0.473）是保护因素。Cox比例风险模型分析显示，与HbA1C控制较好的患者相比，HbA1组、HbA2组和HbA3组的DF风险比（HR）分别为1.25、1.58和4.71。Nomogram模型分析显示，各因素总分范围为44～176分，对应的风险率范围为0.10～0.90分。总分越高，糖尿病患者发生DF的风险越大；列线图模型的曲线下面积为 0.742；95% 置信区间：0。P  < 0.0001)。

结论

预防DF的关键是加强糖尿病患者DF护理教育，提高患者自我管理能力，提高患者血糖控制水平。