Incidence and Risk Factors of Diabetic Foot Syndrome in Patients Early After Pancreas or Kidney/Pancreas Transplantation and its Association with Preventive Measures.
Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Method...
| Publicado en: | International Journal of Lower Extremity Wounds Vol. 23; no. 2; pp. 283 - 291 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Jun2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176929767&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176929767 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15347346 IYG jtl: International Journal of Lower Extremity Wounds issn: 15347346 maglogo: Y pubinfo: dt: Jun2024 vid: 23 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 176929767 153334462 176929767 176929767 10.1177/15347346211052155 176929767 ppf: 283 ppct: 8 formats: tig: atl: Incidence and Risk Factors of Diabetic Foot Syndrome in Patients Early After Pancreas or Kidney/Pancreas Transplantation and its Association with Preventive Measures. aug: au: Vrátná, E. Husáková, J. Králová, K. Kratochvílová, S. Girman, P. Saudek, F. Dubský, M. Bém, R. Wosková, V. Jirkovská, A. Dad'ová, K. Vařeková, J Lánská, V. Fejfarová, V. affil: 156922Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic sug: subj: Diabetic Foot Epidemiology Diabetic Foot Risk Factors Diabetic Foot Prevention and Control Pancreas-Kidney Transplantation Adverse Effects Pancreas-Kidney Transplantation Methods Diabetes Mellitus Complications Preventive Health Care Methods Early Diagnosis Methods Patient Education Methods Risk Assessment Methods Diabetic Patients Psychosocial Factors Human Male Female Adult Middle Age Czech Republic Prospective Studies Logistic Regression Preventive Health Care Diabetic Foot Etiology Transplant Recipients Incidence Postoperative Complications Leisure Activities Physical Examination Foot Deformities Oxygen Kidney Physiology Lower Extremity Physiology Exercise Postoperative Period Descriptive Statistics Funding Source Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Methods: Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. Results: Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p =.0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO2;p =.01), history of DF (p =.0031), deformities (p =.0021) and increased leisure-time physical activity (LTPA) before Tx (p =.037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. Conclusions: Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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