Meta-analysis of risk factors associated with recurrent diabetic foot ulcer
10.3760/cma.j.cn115682-20210802-03422
- VernacularTitle:复发性糖尿病足溃疡相关危险因素的Meta分析
- Author:
Lei XIA
1
;
Ruo ZHUANG
;
Ling WU
;
Min WEI
Author Information
1. 江苏大学医学院护理系，镇江 212001
- Keywords:
Diabetic foot;
Ulcer;
Recurrence;
Risk factors;
Meta-analysis
- From:
Chinese Journal of Modern Nursing
2022;28(9):1143-1148
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the main risk factors of recurrence after wound healing in patients with diabetic foot ulcer (DFU) , so as to provide a basis for clinical prevention of DFU recurrence.Methods:Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang Database, VIP Chinese Science and Technology Journal Full-text Database, and China Biomedical Literature Database were searched by computer, and the risk factors for recurrence of DFU patients were collected from the establishment of the databases to July 10, 2021. Meta-analysis was performed using RevMan 5.3 software.Results:Finally, 12 articles were included, with a total of 2 585 patients, including 982 cases in the recurrence group and 1 603 cases in the non-recurrence group. Meta-analysis results showed that Wagner grade (gradeⅢ, Ⅳ) ( OR=4.40, 95% CI: 2.21-8.78, P<0.01) , accompanied by peripheral neuropathy ( OR=5.69, 95% CI: 4.53-7.14, P<0.01) , accompanied by peripheral vascular disease ( OR=3.54, 95% CI: 3.05-4.11, P<0.01) , multidrug-resistant infection ( OR=3.61, 95% CI: 3.13-4.17, P<0.01) , history of amputation ( OR=19.18, 95% CI: 10.69-34.42, P <0.01) , duration of previous DFU greater than or equal to 60 days ( OR=1.02, 95% CI: 1.00-1.03, P<0.01) , poor blood glucose control ( OR=3.39, 95% CI: 2.67-4.31, P<0.01) , underlying osteomyelitis ( OR=2.86, 95% CI: 2.29-3.58, P<0.01) , initial ulcer on the sole of the foot ( OR=2.80, 95% CI: 2.10-3.73, P<0.01) , smoking ( OR=2.30, 95% CI: 1.18-4.48, P=0.01) were risk factors for DFU recurrence. Conclusions:Based on the available evidence, Wagner grade (gradeⅢ, Ⅳ) , accompanied by peripheral neuropathy, accompanied by peripheral vascular disease, multidrug-resistant infection, history of amputation, duration of previous DFU greater than or equal to 60 days, poor blood glucose control, underlying osteomyelitis, initial ulcer on the sole of the foot and smoking are risk factors for DFU recurrence. Medical staff should pay attention to these influencing factors and take corresponding measures for targeted prevention, so as to improve the quality of diabetic foot care services.
