Analysis Of Related Risk Factors Of Texas Grading And Ulcer Location In Inpatients With Diabetic Foot

Objective:By analyzing the clinical data of inpatients with diabetic foot,to explore the risk factors related to diabetic foot of different Texas grades/stages.Meanwhile,the occurrence site and nature of diabetic foot ulcer were preliminarily analyzed to understand the characteristics of diabetic foot ulcer and provide reference and suggestions for clinical treatment and prevention of diabetic foot.Methods:Clinical data of 125 diabetic foot patients admitted to the department of endocrinology of shandong provincial hospital from January 2016 to October 2018 were collected.According to Texas classification/staging standard,the risk factors affecting the severity of diabetic foot disease were analyzed.Then,diabetic foot patients were divided into nerve ulcer group,ischemic ulcer group and mixed ulcer group according to the causes of foot disease,and the clinical data were compared and analyzed.Results:1.General information of diabetic foot patients(1)Among the 125 DF patients included in this study,84 were male(67.20%)and 41 were female(32.80%).The age distribution was 37-90 years old,with the elderly patients aged 60-79 years old accounting for 59.20%.The days of hospitalization ranged from 8 to 14 days,accounting for 63.20%.The duration of diabetes was the highest in 6-10 years,accounting for 30.40%.The length of diabetic foot disease ranged from 7 to 30 days,accounting for 42.40%.Texas3(44.80%)and D(65.60%)had the most patients.(2)According to the analysis of the ulcer location,toes accounted for 57.6%,sole 8.8%,ankle 5.6%,heel 4.8%,back 4%and toe 3.2%.Can see from this,sufficient toe,sufficient sole,sufficient malleolus,sufficient heel,sufficient back is ulcer good hair place.At the same time,the ulcer of 3 kinds of property all good hair at toe,next,ulcer of ischemic still good hair at plantar.The incidence of mixed ulcer in toe and sole was higher.(3)The causation of ulcer was analyzed.Among the 125 DF patients included in this study,63(50.4%)had clear causation and 62(49.6%)had no clear causation.There are a variety of causes,including shoe abrasions,nail clippings,burns,trauma(including external punctures,scratches,and crush injuries),self-management of callosity,and blisters.Among them,foot ulcer caused by trauma was the most common,accounting for 15.20%.Scalded and worn out shoes accounted for 13.60%and 8.00%respectively.2.Clinical data comparison and risk factor analysis of Texas classification(1)Patients with different DF Texas grades showed statistically significant differences in age,length of stay,NEUT%,ALB,HbA1c,CRP,Fib,FT3 and d-dimer,etc.(P<0.05).(2)The correlation between the above indicators and Texas classification was further analyzed.Speraman test showed that ALB and FT3 were negatively correlated with Texas classification(P<0.05),and hospitalization days,NEUT%,HbAlc,CRP,FIB and d-dimer were positively correlated with Texas classification(P<0.05).3.Clinical data comparison and risk factor analysis of Texas staging(1)Texas patients with different DF stages showed statistically significant differences in length of stay,WBC,Hb,NEUT%,ALB,Fib,FT3,CRP,etc.(2)Similarly,the Speraman test showed that Hb,ALB,FT3 were negatively correlated with Texas staging(P<0.05),and hospitalization days,WBC,NEUT%,CRP,Fib were positively correlated with Texas staging(P<0.05).4.Relationship between Texas classification and staging SPeraman test was used to analyze the correlation between Texas grades and stages,and the correlation coefficient was 0.574,P=0.000(P<0.05),reaching a statistical significance.This indicated that there was a significant correlation between grading and staging.5.The relationship between the indicators of infection and fibrinolysis in diabetic foot patientsPearson test showed that there was a significant correlation between the infection indicators(WBC,NEUT%,CRP)and fibrinolytic indicators(Fib,d-dimer)in 125 diabetic foot patients(P<0.01).6.Other complications and complications of diabetic foot patients 125 DF patients were included in this study,concurrent with diabetic peripheral neuropathy(DPN)88 cases(70.4%),diabetes,peripheral vascular disease(PAD),116 cases(92.80%)and diabetic retinopathy(DR)in 65 cases(52%),diabetic nephropathy(DN)and 55 cases(44%),combination of coronary heart disease(CHD)in 49 cases(39.20%),hypertension,79 cases(63.2%).7.Analysis of factors affecting the nature and predisposing sites of diabetic foot ulcers There was no significant difference in age,length of stay,course of diabetic foot,duration of diabetic foot disease,systolic blood pressure,diastolic blood pressure and other aspects between the three types of ulcers with different natures and different parts of diabetic foot(P>0.05).Conclusion:1.Age,gender and course of diabetes are risk factors for diabetic foot.2.Toes,soles and ankles are the most common sites of diabetic foot.3.There are many inducements for diabetic foot,and the most common one is trauma,followed by scald and wear and tear of shoes.4.Different Texas grades and stages of diabetic foot were correlated.It suggests that the depth of diabetic foot ulcer is closely related to the degree of infection ischemia.5.Hospitalization days,HbA1c,HB,ALB,WBC,NEUT%,CRP,FIB,d-dimer and FT3 were all closely related to the severity of diabetic foot,which could be used as predictors of the severity of DF ulcer.6.There is a close relationship between infection and hypercoagulability in diabetic foot patients.