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Type: Artigo de Periódico
Title: Baseline Characteristics And Risk Factors For Ulcer, Amputation And Severe Neuropathy In Diabetic Foot At Risk: The Brazupa Study
Author: Parisi
MCR; Neto
AM; Menezes
FH; Gomes
MB; Teixeira
RM; de Oliveira
JEP; Pereira
JRD; Fonseca
RMC; Guedes
LBA; Forti
ACE; de Oliveira
AMA; Nobrega
MBD; Colares
VNQ; Schmid
H; Nienov
OH; Nery
M; Fernandes
TD; Pedrosa
HC; de Oliveira
CDS; Ronsoni
M; Rezende
KF; Quilici
MTV; Vieira
AEF; de Macedo
GMC; Stuchi-Perez
EG; Dinhane
KGI; Pace
AE; de Freitas
MCF; Calsolari
MR; Saad
Abstract: Studies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation. Methods: This study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications. Results: Patients with ulcer had longer disease duration (17.2 +/- 9.9 vs. 13.2 +/- 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 +/- 2.03 vs. 8.35 +/- 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2-3.7), smoking (OR 1.78; 95 % CI 1.09-2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31-44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47-3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08-2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65-13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2-3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01-11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43-112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14-0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1-4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67-19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64-7.33). There was no association between either outcome and ethnicity. Conclusions: Ulcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.
Subject: Diabetes
Risk Factors For Ulcer
Severe Neuropathy
Citation: Diabetology & Metabolic Syndrome. BIOMED CENTRAL LTD, n. 8, n. 25, p. .
Rights: aberto
Identifier DOI: 10.1186/s13098-016-0126-8
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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