Hızlı ilerleyici diyabetik ayak yarası hastalarında mortaliteyi etkileyen faktörler

DOI: 10.26650/cjm.2019.43.39Amaç: Hızlı ilerleyici septik enfeksiyonla seyreden diyabetik ayak yaraları son derece ölümcül durumlardır. Bu nedenle hızlı bir cerrahi müdahale gerektirirler. Bu durumların ciddiyetinden ötürü hastalığın epidemiyolojik ve prognostik altyapısının bilinmesi önemlidir. Bu çalışmanın amacı; bu hasta grubunda epidemiyoloji, etiyoloji ve uygulanan cerrahi prosedürlerin mortalite üzerine etkisini araştırmaktır. Yöntemler: Nisan 2006 ile Nisan 2011 arasında acil polikliniğine başvuran ve acil yatış gerektiren 35 diyabetik ayak yarası hastasının kayıtları retrospektif olarak tarandı. Hastaların yaş, cinsiyet, eşlik eden hastalık, diyabet süresi, yara süresi, yara etiyolojisi, mikrobiyolojik inceleme sonuçları, uygulanan cerrahi girişimler, operasyon sonrası yoğun bakım ihtiyacı ve mortaliteleri incelendi. İstatistiksel olarak diğer tüm parametrelerin mortalite ile korelasyonu araştırıldı. Bulgular: Yara süresinin uzun olması ve postoperatif yoğun bakım ihtiyacı istatistiksel olarak anlamlı şekilde mortalite ile korale bulundu (p<0,05). Kardiyak ek hastalık öyküsü bulunan hasta grubunda mortalitenin daha yüksek olduğu görüldü ancak bu fark istatistiksel olarak anlamlı bulunmadı (%24’e %20). Sonuç: Enfekte diyabetik ayak yaraları son derece ölümcül bir seyre sahip olabilir. Akut enfeksiyon ayrımını yapabilmek ve mortalite üzerine etki eden faktörleri bilmek daha iyi bir prognoza ulaşmak için yol gösterici olacaktır.Cite this article as: Demiröz A, Arslan H. Factors Affecting Mortality in Rapidly Progressive Diabetic Foot Ulcer Patients. Cerrahpasa Med J 2019; 43(1): 23-28.

Anahtar Kelimeler:

Diyabetik ayak yarası, enfeksiyon, mortalite, sepsis

Factors Affecting Mortality in Rapidly Progressive Diabetic Foot Ulcer Patients

DOI: 10.26650/cjm.2019.43.39Objective: A diabetic foot ulcer with progressive infection is a life-threatening condition that requires urgent surgical intervention. Because of the severity of this condition, it is important to understand its epidemiological and prognostic background. This study aims to evaluate the epidemiology of the diabetic foot ulcer and describe the etiology and the surgical procedures performed to treat it.Methods: A retrospective review of 35 diabetic patients with foot ulcers was performed. These individuals were admitted to the emergency department and were subsequently hospitalized between April 2006 and April 2011. Factors affecting their mortality were statistically assessed.Results: The long duration of ulcer treatment and need for intensive care were found significantly related to mortality (p<0.05). There was a trend toward higher mortality in the patient group with cardiac comorbidity (24% versus 20%), but this was not found to be statistically significant. Conclusion: Infective diabetic foot ulcers may have a highly mortal course. Having knowledge of how to discriminate between the acute infection and the factors affecting patient mortality may lead us to making better prognoses and delivering more effective treatment.Cite this article as: Demiröz A, Arslan H. Factors Affecting Mortality in Rapidly Progressive Diabetic Foot Ulcer Patients. Cerrahpasa Med J 2019; 43(1): 23-28.

Keywords:

Diabetic foot wound, infection, mortality, sepsis,

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