对快速获得腿部溃疡服务的患者的合并症模式和5年生存率的审计。

Ahmmad Alfatih Ahmmad, Tayyaub Mansoor, Doireann Joyce, Daniel Westby, Colum Keohane, Marie O'Shaughnessy, Stewart Walsh
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引用次数: 0

摘要

背景:虽然腿部溃疡很常见,但有关长期治疗的数据却很有限。历史数据显示,约 50% 的腿部溃疡患者在发病后 5 年内死亡。然而,人们对当代患者的存活率知之甚少。这项回顾性研究旨在评估在血管性腿部溃疡诊所就诊的患者的 5 年生存率。研究目的评估腿部溃疡患者的 5 年存活率,并分析溃疡病因和患者合并疾病对存活率的影响。方法:在 30 个月内(2016 年至 2018 年),对腿部溃疡患者的存活率进行评估:在 30 个月内(2016 年至 2018 年),腿部溃疡诊所对 119 名新患者进行了评估,并随访 5 年。记录了基线合并疾病、溃疡类型、干预措施和 5 年生存率。采用卡普兰-梅耶曲线计算存活率。比较了静脉和动脉/混合型患者的并发症负担和存活率。结果显示5年总生存率为74%。静脉患者的生存率高于动脉/混合型患者(5年死亡率为16/88 vs 15/31;p < .01 log-rank检验)。动脉/混合型患者的并发症较多。在多变量回归模型中,发病时存在三种或三种以上并发症是唯一能显著预测死亡率的因素。结论总体而言,与历史数据相比,腿部溃疡患者的 5 年生存率有所提高,但动脉/混合型患者的 5 年生存率仍保持不变。
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Audit of co-morbidity patterns and 5-year survival among patients presenting to a rapid access leg ulcer service.

Background: While leg ulceration is common, data regarding long-term is limited. Historical data indicate that approximately 50% of leg ulcer patients die within 5 years of presentation. However, little is known regarding survival outcomes in contemporary patient populations. This retrospective study aimed to assess 5-year survival in patients attending a vascular leg ulcer clinic. Objectives: To evaluate 5-year survival among patients with leg ulcers and to analyse the effect of ulcer aetiology and patient co-morbidities on survival. Methods: Over 30 months (2016 to 2018), 119 new patients were assessed at the leg ulcer clinic and followed over 5 years. Baseline co-morbidities, ulcer type, interventions performed, and 5-year survival were recorded. Survival was calculated using Kaplan-Meier curves. Co-morbid burden and survival were compared between venous and arterial/mixed patients. Results: Overall 5-year survival was 74%. Venous patients fared better than arterial/mixed patients (5-year mortality 16/88 vs 15/31; p < .01 log-rank test). Arterial/mixed patients had a greater burden of co-morbidities. In multivariate regression modelling, the presence of three or more co-morbidities at presentation was the only significant predictor of mortality. Conclusions: Overall, 5-year survival for leg ulcer patients has improved compared to historical data but remains static for arterial/mixed patients.

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