Principais fatores de risco para mortalidade de longo prazo em pacientes com úlceras de pé diabético
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Apr 30, 2023
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Resumo
Objetivo: Identificar os principais fatores de risco para mortalidade de longo prazo em pacientes com úlceras de pé diabético. Métodos: Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados SciELO, PubMed, Scopus e Web of Science, por meio dos seguintes descritores: “diabetic foot”, “diabetic feet”, “diabetic foot ulcer”, “diabetic foot complication”, “mortality” e “death”. Foram incluídos estudos publicados entre 2018 a 2022 e que relataram a mortalidade em longo prazo de pacientes com úlceras de pé diabético. Resultados: 11 artigos compuseram a amostra final deste estudo, com maior frequência de estudos retrospectivos (n: 05). Identificou-se que os principais fatores de risco associados à mortalidade a longo prazo de pacientes com úlceras de pé diabético foram: idade avançada, baixo status socioeconômico, tabagismo, duração do diabetes, doença renal crônica, doença arterial periférica, maior grau de gravidade da úlcera e presença de amputação anterior. Conclusão: Conclui-se que diversas condições podem elevar a probabilidade de ocorrência de óbito à longo prazo em pacientes com úlceras de pé diabético, como características clínicas gerais e da úlcera e sociodemográficas. Desta forma, o rastreio e a gestão desses fatores de risco devem continuar a serem aspetos importantes das políticas de promoção da saúde.
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Como Citar
GomesG. V. A., SilvaD. R. P. da, LimaC. M. e, MadeiraJ. F., CarvalhoB. M. M., VanderleyA. M., & NascimentoJ. W. A. do. (2023). Principais fatores de risco para mortalidade de longo prazo em pacientes com úlceras de pé diabético. Revista Eletrônica Acervo Saúde, 23(4), e12620. https://doi.org/10.25248/reas.e12620.2023
Seção
Revisão Bibliográfica
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Referências
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2. AMADOU C, et al. Five-year mortality in patients with diabetic foot ulcer during 2009–2010 was lower than expected. Diabetes Metab, 2020; 46(3): 230-235.
3. ARMSTRONG DG, et al. Foot Ulcers and Their Recurrence. N Engl J Med, 2017; 376(24): 2367-2375.
4. ARMSTRONG DG, et al. Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer. Journal of Foot and Ankle Research, 2020; 13.
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6. BRENNAN MB, et al. Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes. J. Diabetes Complicat, 2017; 31: 556–561.
7. CAVALLARI I, et al. Causes and risk factors for death in diabetes: a competing-risk analysis from the SAVOR-TIMI 53 trial. J Am Coll Cardiol, 2021; 77(14): 1837-1840.
8. CHAMMAS NK, et al. Increased mortality in diabetic foot ulcer patients: the significance of ulcer type. J Diabetes Res, 2016; 2879809.
9. CORREIA EF, et al. Principais fatores de risco para amputação de membros inferiores em pacientes com pé diabético: uma revisão sistemática. Research, Society and Development, 2022; 11(8): e59511831599.
10. COSTA RHR, et al. Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia. Diabetes Metabol Syndr, 2017; 11 (2): 583-587.
11. DIETRICH I, et al. The diabetic foot as a proxy for cardiovascular events and mortality review. Curr Atherosclerosis Rep, 2017; 19: 44.
12. EDUARDO LS, et al. Principais evidências clínicas da oxigenoterapia hiperbárica no tratamento de úlceras de pé diabético: uma revisão sistemática. Research, Society and Development, 2022; 11(10): e312111032780.
13. GUARNOTTA V, et al. Diabetic foot ulcers: retrospective comparative analysis from Sicily between two eras. PLoS One, 2021; 16(12): e0259405.
14. HA JH, et al. Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea. BMC Public Health, 2021; 21(1): 1395.
15. HOFFSTAD O, et al. Diabetes, lower-extremity amputation, and death. Diabetes Care, 2015; 38: 1852–1857.
16. JEYARAMAN K, et al. Mortality in patients with diabetic foot ulcer: a retrospective study of 513 cases from a single Centre in the Northern Territory of Australia. BMC Endocr Disord, 2019; 19(1): 1.
17. JOLISSAINT JS, et al. Risk prediction of 30-day mortality after lower extremity major amputation. J Vasc Surg, 2019; 70(6): 1868–1876.
18. JUPITER DC, et al. The impact of foot ulceration and amputation on mortality in diabetic patients. I: from ulceration to death, a systematic review. Int Wound J, 2016; 13: 892–903.
19. LU Q, et al. Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients. Diabetes, Metabolic Syndrome and Obesity, 2021; 14: 2019-2027.
20. MADER JK, et al. Patients with healed diabetic foot ulcer represent a cohort at highest risk for future fatal events. Sci Rep, 2019; 9(1): 10325.
21. MARTINS-MENDES D, et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complicat, 2014; 28:632-8.
22. MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
23. NASCIMENTO JWA, et al. Complications associated with intimate partner violence in pregnant women: a systematic review. Int. J. Dev. Res, 2021; 11(7): 48924-48928.
24. OGURTSOVA K, et al. IDF diabetes Atlas: global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract, 2022; 183: 109118.
25. PEREIRA AS, et al. Metodologia da pesquisa científica. (1ª ed.): UFSM, NTE, 2018.
26. PIAGGESI A, et al. Diabetic foot surgery “made in Italy”. Results of 15 years of activity of a third-level Centre managed by diabetologists. Diabetes Res Clin Pract, 2020; 167: 108355.
27. RASTOGI A, et al. Long term outcomes after incident diabetic foot ulcer: multicenter large cohort prospective study (EDI-FOCUS investigators) epidemiology of diabetic foot complications study: epidemiology of diabetic foot complications study. Diabetes Res Clin Pract, 2020; 162: 108113.
28. ROSI LM, et al. Demographics and outcomes of inpatients with diabetic foot ulcers treated conservatively and surgically in a metropolitan hospital network. Diabetes Res Clin Pract, 2021; 175: 108821.
29. ROTH GA, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019 update from the GBD 2019 study. J Am Coll Cardiol, 2020; 76(25): 2982-3021.
30. RUBIO JA, et al. Mortality in patients with diabetic foot ulcers: causes, risk factors, and their association with evolution and severity of ulcer. J Clin Med, 2020; 9(9): 3009.
31. SCAIN SF, et al. Riscos associados à mortalidade em pacientes atendidos em um programa de prevenção do pé diabético. Rev. Gaúcha Enferm, 2018; 39: e20170230.
32. Sigvant B, et al. The risk of disease progression in peripheral arterial disease is higher than expected: a meta-analysis of mortality and disease progression in peripheral arterial disease. Eur J Vasc Endovasc Surg, 2016; 51: 395-403.
33. SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (São Paulo), 2010; 8(1): 102-106.
34. STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
35. THORUD JC, et al. Mortality after nontraumatic major amputation among patients with diabetes and peripheral vascular disease: a systematic review. J Foot Ankle Surg, 2016; 55: 591-599.
36. TROISI N, et al. Influence of pedal arch quality on 5-year survival and limb salvage in patients with diabetic foot ulcers undergoing peripheral angiography. Vascular, 2021; 30(5).
37. VAN BAAL J, et al. Mortality associated with acute Charcot foot and neuropathic foot ulceration. Diabetes Care, 2010; 33: 1086–1089.
38. WALSH JW, et al. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet. Med, 2016; 33: 1493-1498.
39. WOLF G, et al. Diabetic foot syndrome and renal function in type 1 and 2 diabetes mellitus show close association. Nephrol Dial Transplant, 2009; 24(6): 1896–1901.
40. WUKICH DK, et al. Comparison of transtibial amputations in diabetic patients with and without end-stage renal disease. Foot Ankle Int, 2017; 38(4): 388-396.
2. AMADOU C, et al. Five-year mortality in patients with diabetic foot ulcer during 2009–2010 was lower than expected. Diabetes Metab, 2020; 46(3): 230-235.
3. ARMSTRONG DG, et al. Foot Ulcers and Their Recurrence. N Engl J Med, 2017; 376(24): 2367-2375.
4. ARMSTRONG DG, et al. Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer. Journal of Foot and Ankle Research, 2020; 13.
5. BRASIL. Ministério da Saúde (MS). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde, 1998.
6. BRENNAN MB, et al. Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes. J. Diabetes Complicat, 2017; 31: 556–561.
7. CAVALLARI I, et al. Causes and risk factors for death in diabetes: a competing-risk analysis from the SAVOR-TIMI 53 trial. J Am Coll Cardiol, 2021; 77(14): 1837-1840.
8. CHAMMAS NK, et al. Increased mortality in diabetic foot ulcer patients: the significance of ulcer type. J Diabetes Res, 2016; 2879809.
9. CORREIA EF, et al. Principais fatores de risco para amputação de membros inferiores em pacientes com pé diabético: uma revisão sistemática. Research, Society and Development, 2022; 11(8): e59511831599.
10. COSTA RHR, et al. Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia. Diabetes Metabol Syndr, 2017; 11 (2): 583-587.
11. DIETRICH I, et al. The diabetic foot as a proxy for cardiovascular events and mortality review. Curr Atherosclerosis Rep, 2017; 19: 44.
12. EDUARDO LS, et al. Principais evidências clínicas da oxigenoterapia hiperbárica no tratamento de úlceras de pé diabético: uma revisão sistemática. Research, Society and Development, 2022; 11(10): e312111032780.
13. GUARNOTTA V, et al. Diabetic foot ulcers: retrospective comparative analysis from Sicily between two eras. PLoS One, 2021; 16(12): e0259405.
14. HA JH, et al. Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea. BMC Public Health, 2021; 21(1): 1395.
15. HOFFSTAD O, et al. Diabetes, lower-extremity amputation, and death. Diabetes Care, 2015; 38: 1852–1857.
16. JEYARAMAN K, et al. Mortality in patients with diabetic foot ulcer: a retrospective study of 513 cases from a single Centre in the Northern Territory of Australia. BMC Endocr Disord, 2019; 19(1): 1.
17. JOLISSAINT JS, et al. Risk prediction of 30-day mortality after lower extremity major amputation. J Vasc Surg, 2019; 70(6): 1868–1876.
18. JUPITER DC, et al. The impact of foot ulceration and amputation on mortality in diabetic patients. I: from ulceration to death, a systematic review. Int Wound J, 2016; 13: 892–903.
19. LU Q, et al. Risk Factors for Major Amputation in Diabetic Foot Ulcer Patients. Diabetes, Metabolic Syndrome and Obesity, 2021; 14: 2019-2027.
20. MADER JK, et al. Patients with healed diabetic foot ulcer represent a cohort at highest risk for future fatal events. Sci Rep, 2019; 9(1): 10325.
21. MARTINS-MENDES D, et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complicat, 2014; 28:632-8.
22. MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
23. NASCIMENTO JWA, et al. Complications associated with intimate partner violence in pregnant women: a systematic review. Int. J. Dev. Res, 2021; 11(7): 48924-48928.
24. OGURTSOVA K, et al. IDF diabetes Atlas: global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract, 2022; 183: 109118.
25. PEREIRA AS, et al. Metodologia da pesquisa científica. (1ª ed.): UFSM, NTE, 2018.
26. PIAGGESI A, et al. Diabetic foot surgery “made in Italy”. Results of 15 years of activity of a third-level Centre managed by diabetologists. Diabetes Res Clin Pract, 2020; 167: 108355.
27. RASTOGI A, et al. Long term outcomes after incident diabetic foot ulcer: multicenter large cohort prospective study (EDI-FOCUS investigators) epidemiology of diabetic foot complications study: epidemiology of diabetic foot complications study. Diabetes Res Clin Pract, 2020; 162: 108113.
28. ROSI LM, et al. Demographics and outcomes of inpatients with diabetic foot ulcers treated conservatively and surgically in a metropolitan hospital network. Diabetes Res Clin Pract, 2021; 175: 108821.
29. ROTH GA, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019 update from the GBD 2019 study. J Am Coll Cardiol, 2020; 76(25): 2982-3021.
30. RUBIO JA, et al. Mortality in patients with diabetic foot ulcers: causes, risk factors, and their association with evolution and severity of ulcer. J Clin Med, 2020; 9(9): 3009.
31. SCAIN SF, et al. Riscos associados à mortalidade em pacientes atendidos em um programa de prevenção do pé diabético. Rev. Gaúcha Enferm, 2018; 39: e20170230.
32. Sigvant B, et al. The risk of disease progression in peripheral arterial disease is higher than expected: a meta-analysis of mortality and disease progression in peripheral arterial disease. Eur J Vasc Endovasc Surg, 2016; 51: 395-403.
33. SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (São Paulo), 2010; 8(1): 102-106.
34. STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
35. THORUD JC, et al. Mortality after nontraumatic major amputation among patients with diabetes and peripheral vascular disease: a systematic review. J Foot Ankle Surg, 2016; 55: 591-599.
36. TROISI N, et al. Influence of pedal arch quality on 5-year survival and limb salvage in patients with diabetic foot ulcers undergoing peripheral angiography. Vascular, 2021; 30(5).
37. VAN BAAL J, et al. Mortality associated with acute Charcot foot and neuropathic foot ulceration. Diabetes Care, 2010; 33: 1086–1089.
38. WALSH JW, et al. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet. Med, 2016; 33: 1493-1498.
39. WOLF G, et al. Diabetic foot syndrome and renal function in type 1 and 2 diabetes mellitus show close association. Nephrol Dial Transplant, 2009; 24(6): 1896–1901.
40. WUKICH DK, et al. Comparison of transtibial amputations in diabetic patients with and without end-stage renal disease. Foot Ankle Int, 2017; 38(4): 388-396.