Factores de riesgo para amputación en pacientes con pie diabético en el Servicio de Cirugía Vascular del Hospital Abel Gilbert Pontón desde enero a diciembre del 2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
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El pie diabético es la infección, ulceración y destrucción de los tejidos profundos, asociado a anormalidades neurológicas y vasculopatía periférica en las extremidades inferiores. La amputación de miembros inferiores es la consecuencia más severa del pie diabético, pues afecta tanto física como psicológicamente a la persona que la padece, además de producir una disminución notable en la calidad de vida o institucionalización debido al incremento de costes socioeconómicos para su cuidado. Aproximadamente el 15% de las personas diabéticas desarrollará una úlcera a lo largo de su vida. Se utilizó como método de recolección de datos, la revisión de expedientes clínicos de los pacientes con diagnóstico de Pie Diabético que fueron admitidos en la unidad de emergencia del Hospital Abel Gilbert Pontón durante el periodo de Enero a Diciembre del 2016 El universo del estudio correspondió a 364 pacientes, de los cuales 192 fueron sometidos a amputación. En el presente estudio las amputaciones fueron más frecuentes en el sexo femenino, los pacientes consultan por estadios avanzados de pie diabético (el 50% se encuentra en el grado V según la clasificación de Wagner); el 57% de los pacientes amputados presentaron a Glicemia mayor de 200 mg/dl al momento del ingreso; de los pacientes amputados el 43% presentó Hemoglobina Glicosilada mayor de 8.7%. Únicamente el 12% refirió uso de Ortesis de descarga, mientras el 88% negó su uso. Se concluye que el pie diabético es una complicación frecuente de la Diabetes Mellitus y que el 52% de los pacientes ingresados con este diagnóstico, terminan en amputación menor o mayor, con las consecuencias físicas y psicológicas que aquello conlleva. El mal control glicémico y la falta de educación en cuanto al cuidado de los pies pueden ser los principales factores asociados con la frecuencia de las amputaciones.
Diabetic foot is the infection, ulceration and destruction of the deep tissues, associated to neurological abnormalities and peripheral vasculopathy in the lower extremities. Amputation of lower limbs is the most severe consequence of the diabetic foot, as it affects both the physical and psychologically the person suffering from it, as well as producing a notable decrease in the quality of life or institutionalization due to the increase in socioeconomic costs for its care. Approximately 15% of people with diabetes will develop an ulcer throughout their life. We used as a method of data collection, the review of clinical records of patients diagnosed with Diabetic Foot who were admitted to the emergency unit of the Hospital Abel Gilbert Pontón during the period from January to December of 2016. The universe of the study corresponded to 364 patients, of whom 192 underwent amputation. In the present study, amputations were more frequent in females, patients were consulted for advanced stages of diabetic foot (50% were in grade V according to the Wagner classification); 57% of the amputees presented with glycemia greater than 200 mg / dl at the time of admission; Of the amputated patients, 43% presented glycosylated hemoglobin greater than 8.7%. Only 12% reported use of discharge orthoses, while 88% denied their use. It is concluded that diabetic foot is a frequent complication of Diabetes Mellitus and that 52% of the patients admitted with this diagnosis end up in less or greater amputation, with the physical and psychological consequences that this entails. Poor glycemic control and lack of education in foot care may be the main factors associated with the frequency of amputations.
Diabetic foot is the infection, ulceration and destruction of the deep tissues, associated to neurological abnormalities and peripheral vasculopathy in the lower extremities. Amputation of lower limbs is the most severe consequence of the diabetic foot, as it affects both the physical and psychologically the person suffering from it, as well as producing a notable decrease in the quality of life or institutionalization due to the increase in socioeconomic costs for its care. Approximately 15% of people with diabetes will develop an ulcer throughout their life. We used as a method of data collection, the review of clinical records of patients diagnosed with Diabetic Foot who were admitted to the emergency unit of the Hospital Abel Gilbert Pontón during the period from January to December of 2016. The universe of the study corresponded to 364 patients, of whom 192 underwent amputation. In the present study, amputations were more frequent in females, patients were consulted for advanced stages of diabetic foot (50% were in grade V according to the Wagner classification); 57% of the amputees presented with glycemia greater than 200 mg / dl at the time of admission; Of the amputated patients, 43% presented glycosylated hemoglobin greater than 8.7%. Only 12% reported use of discharge orthoses, while 88% denied their use. It is concluded that diabetic foot is a frequent complication of Diabetes Mellitus and that 52% of the patients admitted with this diagnosis end up in less or greater amputation, with the physical and psychological consequences that this entails. Poor glycemic control and lack of education in foot care may be the main factors associated with the frequency of amputations.
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Diabetes mellitus tipo 2, Pie diabético, Amputación, Factores de riesgo, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador