Special Topics: Diabetic Foot Nursing
Meta-analysis of risk factors associated with recurrent diabetic foot ulcer
Xia Lei, Zhuang Ruo, Wu Ling, Wei Min
Published 2022-03-26
Cite as Chin J Mod Nurs, 2022, 28(9): 1143-1148. DOI: 10.3760/cma.j.cn115682-20210802-03422
Abstract
ObjectiveTo analyze the main risk factors of recurrence after wound healing in patients with diabetic foot ulcer (DFU) , so as to provide a basis for clinical prevention of DFU recurrence.
MethodsCochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang Database, VIP Chinese Science and Technology Journal Full-text Database, and China Biomedical Literature Database were searched by computer, and the risk factors for recurrence of DFU patients were collected from the establishment of the databases to July 10, 2021. Meta-analysis was performed using RevMan 5.3 software.
ResultsFinally, 12 articles were included, with a total of 2 585 patients, including 982 cases in the recurrence group and 1 603 cases in the non-recurrence group. Meta-analysis results showed that Wagner grade (gradeⅢ, Ⅳ) (OR=4.40, 95%CI: 2.21-8.78, P<0.01) , accompanied by peripheral neuropathy (OR=5.69, 95%CI: 4.53-7.14, P<0.01) , accompanied by peripheral vascular disease (OR=3.54, 95%CI: 3.05-4.11, P<0.01) , multidrug-resistant infection (OR=3.61, 95%CI: 3.13-4.17, P<0.01) , history of amputation (OR=19.18, 95%CI: 10.69-34.42, P <0.01) , duration of previous DFU greater than or equal to 60 days (OR=1.02, 95%CI: 1.00-1.03, P<0.01) , poor blood glucose control (OR=3.39, 95%CI: 2.67-4.31, P<0.01) , underlying osteomyelitis (OR=2.86, 95%CI: 2.29-3.58, P<0.01) , initial ulcer on the sole of the foot (OR=2.80, 95%CI: 2.10-3.73, P<0.01) , smoking (OR=2.30, 95%CI: 1.18-4.48, P=0.01) were risk factors for DFU recurrence.
ConclusionsBased on the available evidence, Wagner grade (gradeⅢ, Ⅳ) , accompanied by peripheral neuropathy, accompanied by peripheral vascular disease, multidrug-resistant infection, history of amputation, duration of previous DFU greater than or equal to 60 days, poor blood glucose control, underlying osteomyelitis, initial ulcer on the sole of the foot and smoking are risk factors for DFU recurrence. Medical staff should pay attention to these influencing factors and take corresponding measures for targeted prevention, so as to improve the quality of diabetic foot care services.
Key words:
Diabetic foot; Ulcer; Recurrence; Risk factors; Meta-analysis
Contributor Information
Xia Lei
School of Nursing, School of Medicine, Jiangsu University, Zhenjiang 212001, China
Zhuang Ruo
Department of Nursing, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China
Wu Ling
Wound Care Clinic, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Wei Min
Wound Care Clinic, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
