Morbidity and mortality of infected diabetic foot managed in general surgical department.
Identifieur interne : 000571 ( Main/Exploration ); précédent : 000570; suivant : 000572Morbidity and mortality of infected diabetic foot managed in general surgical department.
Auteurs : Esma Leila Gouta ; Mehdi Khalfallah ; Wejih Dougaz ; Imene Samaali ; Ramzi Nouira ; Ibtissem Bouasker ; Chadli DziriSource :
- La Tunisie medicale [ 0041-4131 ] ; 2018.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Amputation chirurgicale (mortalité), Amputation chirurgicale (statistiques et données numériques), Durée du séjour (statistiques et données numériques), Débridement (mortalité), Débridement (statistiques et données numériques), Défaillance cardiaque (mortalité), Défaillance cardiaque (épidémiologie), Défaillance multiviscérale (mortalité), Défaillance multiviscérale (épidémiologie), Femelle (MeSH), Humains (MeSH), Infection de plaie (chirurgie), Infection de plaie (complications), Infection de plaie (mortalité), Infection de plaie (épidémiologie), Morbidité (MeSH), Mortalité (MeSH), Mortalité hospitalière (MeSH), Mâle (MeSH), Pied diabétique (chirurgie), Pied diabétique (complications), Pied diabétique (mortalité), Pied diabétique (épidémiologie), Procédures de chirurgie opératoire (mortalité), Procédures de chirurgie opératoire (méthodes), Procédures de chirurgie opératoire (statistiques et données numériques), Services hospitaliers (MeSH), Sujet âgé (MeSH), Tunisie (épidémiologie), Études rétrospectives (MeSH).
- MESH :
- chirurgie : Infection de plaie, Pied diabétique.
- mortalité : Amputation chirurgicale, Débridement, Défaillance cardiaque, Défaillance multiviscérale, Infection de plaie, Pied diabétique, Procédures de chirurgie opératoire.
- méthodes : Procédures de chirurgie opératoire.
- statistiques et données numériques : Amputation chirurgicale, Durée du séjour, Débridement, Procédures de chirurgie opératoire.
- épidémiologie : Défaillance cardiaque, Défaillance multiviscérale, Infection de plaie, Pied diabétique, Tunisie.
- Adulte d'âge moyen, Femelle, Humains, Morbidité, Mortalité, Mortalité hospitalière, Mâle, Services hospitaliers, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : Tunisie.
English descriptors
- KwdEn :
- Aged (MeSH), Amputation (mortality), Amputation (statistics & numerical data), Debridement (mortality), Debridement (statistics & numerical data), Diabetic Foot (complications), Diabetic Foot (epidemiology), Diabetic Foot (mortality), Diabetic Foot (surgery), Female (MeSH), Heart Failure (epidemiology), Heart Failure (mortality), Hospital Departments (MeSH), Hospital Mortality (MeSH), Humans (MeSH), Length of Stay (statistics & numerical data), Male (MeSH), Middle Aged (MeSH), Morbidity (MeSH), Mortality (MeSH), Multiple Organ Failure (epidemiology), Multiple Organ Failure (mortality), Retrospective Studies (MeSH), Surgical Procedures, Operative (methods), Surgical Procedures, Operative (mortality), Surgical Procedures, Operative (statistics & numerical data), Tunisia (epidemiology), Wound Infection (complications), Wound Infection (epidemiology), Wound Infection (mortality), Wound Infection (surgery).
- MESH :
- geographic , epidemiology : Tunisia.
- complications : Diabetic Foot, Wound Infection.
- epidemiology : Diabetic Foot, Heart Failure, Multiple Organ Failure, Wound Infection.
- methods : Surgical Procedures, Operative.
- mortality : Amputation, Debridement, Diabetic Foot, Heart Failure, Multiple Organ Failure, Surgical Procedures, Operative, Wound Infection.
- statistics & numerical data : Amputation, Debridement, Length of Stay, Surgical Procedures, Operative.
- surgery : Diabetic Foot, Wound Infection.
- Aged, Female, Hospital Departments, Hospital Mortality, Humans, Male, Middle Aged, Morbidity, Mortality, Retrospective Studies.
Abstract
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.
PubMed: 31131868
Affiliations:
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last="Bouasker">Ibtissem Bouasker</name></author><author><name sortKey="Dziri, Chadli" sort="Dziri, Chadli" uniqKey="Dziri C" first="Chadli" last="Dziri">Chadli Dziri</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2018">2018</date><idno type="RBID">pubmed:31131868</idno><idno type="pmid">31131868</idno><idno type="wicri:Area/PubMed/Corpus">000248</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000248</idno><idno type="wicri:Area/PubMed/Curation">000247</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000247</idno><idno type="wicri:Area/PubMed/Checkpoint">000332</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000332</idno><idno type="wicri:Area/Main/Merge">000571</idno><idno type="wicri:Area/Main/Curation">000571</idno><idno type="wicri:Area/Main/Exploration">000571</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Morbidity and mortality of infected diabetic foot managed in general surgical department.</title><author><name sortKey="Gouta, Esma Leila" sort="Gouta, Esma Leila" uniqKey="Gouta E" first="Esma Leila" last="Gouta">Esma Leila Gouta</name></author><author><name sortKey="Khalfallah, Mehdi" sort="Khalfallah, Mehdi" uniqKey="Khalfallah M" first="Mehdi" last="Khalfallah">Mehdi Khalfallah</name></author><author><name sortKey="Dougaz, Wejih" sort="Dougaz, Wejih" uniqKey="Dougaz W" first="Wejih" last="Dougaz">Wejih Dougaz</name></author><author><name sortKey="Samaali, Imene" sort="Samaali, Imene" uniqKey="Samaali I" first="Imene" last="Samaali">Imene Samaali</name></author><author><name sortKey="Nouira, Ramzi" sort="Nouira, Ramzi" uniqKey="Nouira R" first="Ramzi" last="Nouira">Ramzi Nouira</name></author><author><name sortKey="Bouasker, Ibtissem" sort="Bouasker, Ibtissem" uniqKey="Bouasker I" first="Ibtissem" last="Bouasker">Ibtissem Bouasker</name></author><author><name sortKey="Dziri, Chadli" sort="Dziri, Chadli" uniqKey="Dziri C" first="Chadli" last="Dziri">Chadli Dziri</name></author></analytic><series><title level="j">La Tunisie medicale</title><idno type="ISSN">0041-4131</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Amputation (mortality)</term><term>Amputation (statistics & numerical data)</term><term>Debridement (mortality)</term><term>Debridement (statistics & numerical data)</term><term>Diabetic Foot (complications)</term><term>Diabetic Foot (epidemiology)</term><term>Diabetic Foot (mortality)</term><term>Diabetic Foot (surgery)</term><term>Female (MeSH)</term><term>Heart Failure (epidemiology)</term><term>Heart Failure (mortality)</term><term>Hospital Departments (MeSH)</term><term>Hospital Mortality (MeSH)</term><term>Humans (MeSH)</term><term>Length of Stay (statistics & numerical data)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Morbidity (MeSH)</term><term>Mortality (MeSH)</term><term>Multiple Organ Failure (epidemiology)</term><term>Multiple Organ Failure (mortality)</term><term>Retrospective Studies (MeSH)</term><term>Surgical Procedures, Operative (methods)</term><term>Surgical Procedures, Operative (mortality)</term><term>Surgical Procedures, Operative (statistics & numerical data)</term><term>Tunisia (epidemiology)</term><term>Wound Infection (complications)</term><term>Wound Infection (epidemiology)</term><term>Wound Infection (mortality)</term><term>Wound Infection (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Amputation chirurgicale (mortalité)</term><term>Amputation chirurgicale (statistiques et données numériques)</term><term>Durée du séjour (statistiques et données numériques)</term><term>Débridement (mortalité)</term><term>Débridement (statistiques et données numériques)</term><term>Défaillance cardiaque (mortalité)</term><term>Défaillance cardiaque (épidémiologie)</term><term>Défaillance multiviscérale (mortalité)</term><term>Défaillance multiviscérale (épidémiologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Infection de plaie (chirurgie)</term><term>Infection de plaie (complications)</term><term>Infection de plaie (mortalité)</term><term>Infection de plaie (épidémiologie)</term><term>Morbidité (MeSH)</term><term>Mortalité (MeSH)</term><term>Mortalité hospitalière (MeSH)</term><term>Mâle (MeSH)</term><term>Pied diabétique (chirurgie)</term><term>Pied diabétique (complications)</term><term>Pied diabétique (mortalité)</term><term>Pied diabétique (épidémiologie)</term><term>Procédures de chirurgie opératoire (mortalité)</term><term>Procédures de chirurgie opératoire (méthodes)</term><term>Procédures de chirurgie opératoire (statistiques et données numériques)</term><term>Services hospitaliers (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Tunisie (épidémiologie)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Tunisia</term></keywords><keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Infection de plaie</term><term>Pied diabétique</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Diabetic Foot</term><term>Wound Infection</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Diabetic Foot</term><term>Heart Failure</term><term>Multiple Organ Failure</term><term>Wound Infection</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Surgical Procedures, Operative</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Amputation</term><term>Debridement</term><term>Diabetic Foot</term><term>Heart Failure</term><term>Multiple Organ Failure</term><term>Surgical Procedures, Operative</term><term>Wound Infection</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Amputation chirurgicale</term><term>Débridement</term><term>Défaillance cardiaque</term><term>Défaillance multiviscérale</term><term>Infection de plaie</term><term>Pied diabétique</term><term>Procédures de chirurgie opératoire</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Procédures de chirurgie opératoire</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Amputation</term><term>Debridement</term><term>Length of Stay</term><term>Surgical Procedures, Operative</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Amputation chirurgicale</term><term>Durée du séjour</term><term>Débridement</term><term>Procédures de chirurgie opératoire</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Diabetic Foot</term><term>Wound Infection</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Défaillance cardiaque</term><term>Défaillance multiviscérale</term><term>Infection de plaie</term><term>Pied diabétique</term><term>Tunisie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Hospital Departments</term><term>Hospital Mortality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Morbidity</term><term>Mortality</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Morbidité</term><term>Mortalité</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Services hospitaliers</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Tunisie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Bouasker, Ibtissem" sort="Bouasker, Ibtissem" uniqKey="Bouasker I" first="Ibtissem" last="Bouasker">Ibtissem Bouasker</name><name sortKey="Dougaz, Wejih" sort="Dougaz, Wejih" uniqKey="Dougaz W" first="Wejih" last="Dougaz">Wejih Dougaz</name><name sortKey="Dziri, Chadli" sort="Dziri, Chadli" uniqKey="Dziri C" first="Chadli" last="Dziri">Chadli Dziri</name><name sortKey="Gouta, Esma Leila" sort="Gouta, Esma Leila" uniqKey="Gouta E" first="Esma Leila" last="Gouta">Esma Leila Gouta</name><name sortKey="Khalfallah, Mehdi" sort="Khalfallah, Mehdi" uniqKey="Khalfallah M" first="Mehdi" last="Khalfallah">Mehdi Khalfallah</name><name sortKey="Nouira, Ramzi" sort="Nouira, Ramzi" uniqKey="Nouira R" first="Ramzi" last="Nouira">Ramzi Nouira</name><name sortKey="Samaali, Imene" sort="Samaali, Imene" uniqKey="Samaali I" first="Imene" last="Samaali">Imene Samaali</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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