Factores asociados y manifestaciones clínicas del pie diabético en pacientes geriátricos
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2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
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El pie diabético es una complicación crónica prevenible de la diabetes mellitus. Esta es la primera causa de amputación no traumática a nivel mundial. El pie diabético se produce como consecuencia de una suma de factores asociados, entre estos se encuentran la neuropatía, la enfermedad vascular periférica y traumatismos menores y repetitivos. Las úlceras que se producen son de origen neuropático, isquémico o neuroisquémica, siendo esta última la que se presenta con mayor frecuencia, sólo una pequeña proporción de úlceras son puramente isquémicas o neuropáticas. La educación preventiva, un autoexamen, controles metabólicos en la atención primaria de salud, el apego al tratamiento médico son aspectos que ayudan a reducir los índices de amputación. Sin embargo, según datos reportados por el INEC la diabetes mellitus es la segunda causa de muerte en nuestro país, aunque no especifica el tipo de complicación que se haya presentado. A pesar de los esquemas terapéuticos, del tratamiento médico, existen factores que influyen en el riesgo de amputación. Objetivo: determinar los factores asociados y manifestaciones clínicas del pie diabético en pacientes geriátricos. Metodología: Se realizó un estudio cuantitativo, observacional no experimental, transversal, retrospectivo y analítico. Resultados: de una muestra de 73 casos, se observó que aquellos pacientes hospitalizados con determinaciones glicémicas superiores al objetivo glicémico tienen seis veces más probabilidades de riesgo de amputación. Cerca del 46,58% de pacientes con diagnóstico de pie diabético terminaron con amputación total o parcial del miembro afecto. Entre otros factores de riesgo encontramos la nefropatía diabética y los antecedentes de úlceras o amputaciones previas. Conclusiones: Aunque la amputación forma parte del tratamiento, este se considera más bien un fracaso del tratamiento médico. Existe una correlación estrecha entre el índice glicémico y el riesgo de amputación.
Diabetic foot is a preventable chronic complication of diabetes mellitus. This is the leading cause of non-traumatic amputation worldwide. The diabetic foot occurs as a consequence of a sum of associated factors, among these are neuropathy, peripheral vascular disease and minor and repetitive trauma. The ulcers that occur are of neuropathic, ischemic or neuroischemic origin, the latter being the one that occurs most frequently, only a small proportion of ulcers are purely ischemic or neuropathic. Preventive education, a self-examination, metabolic controls in primary health care, adherence to medical treatment are aspects that help reduce amputation rates. However, according to data reported by the INEC, diabetes mellitus is the second leading cause of death in our country, although it does not specify the type of complication that has occurred. Despite the therapeutic schemes and medical treatment, there are factors that influence the risk of amputation. Objective: to determine the associated factors and clinical manifestations of diabetic foot in geriatric patients. Methodology: A quantitative, non-experimental, cross-sectional, retrospective and analytical study was carried out. Results: from a sample of 73 cases, it was observed that those hospitalized patients with glycemic determinations higher than the glycemic target have six times more probabilities of amputation risk. About 46.58% of patients diagnosed with diabetic foot ended up with total or partial amputation of the affected limb. Among other risk factors we find diabetic nephropathy and a history of ulcers or previous amputations. Conclusions: Although amputation is part of the treatment, it is considered rather a failure of medical treatment. There is a close correlation between the glycemic index and the risk of amputation.
Diabetic foot is a preventable chronic complication of diabetes mellitus. This is the leading cause of non-traumatic amputation worldwide. The diabetic foot occurs as a consequence of a sum of associated factors, among these are neuropathy, peripheral vascular disease and minor and repetitive trauma. The ulcers that occur are of neuropathic, ischemic or neuroischemic origin, the latter being the one that occurs most frequently, only a small proportion of ulcers are purely ischemic or neuropathic. Preventive education, a self-examination, metabolic controls in primary health care, adherence to medical treatment are aspects that help reduce amputation rates. However, according to data reported by the INEC, diabetes mellitus is the second leading cause of death in our country, although it does not specify the type of complication that has occurred. Despite the therapeutic schemes and medical treatment, there are factors that influence the risk of amputation. Objective: to determine the associated factors and clinical manifestations of diabetic foot in geriatric patients. Methodology: A quantitative, non-experimental, cross-sectional, retrospective and analytical study was carried out. Results: from a sample of 73 cases, it was observed that those hospitalized patients with glycemic determinations higher than the glycemic target have six times more probabilities of amputation risk. About 46.58% of patients diagnosed with diabetic foot ended up with total or partial amputation of the affected limb. Among other risk factors we find diabetic nephropathy and a history of ulcers or previous amputations. Conclusions: Although amputation is part of the treatment, it is considered rather a failure of medical treatment. There is a close correlation between the glycemic index and the risk of amputation.
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FACTORES DE RIESGO, PIE DIABETICO, AMPUTACION, DIABETES MELLITUS, SOCIEDAD ECUATORIANA DEL PIE DIABETICO, HOSPITAL GENERAL MARTIN ICAZA, CANTON BABAHOYO, ECUADOR, ANCIANO, EPIDEMIOLOGIA DESCRIPTIVA