Caracterização dos portadores de diabetes submetidos à amputação de membros inferiores em Londrina, Estado do Paraná

Abstract

ABSTRACT. Characterization of diabetic patients submitted to lower limb amputation in Londrina, Paraná State. This is a descriptive study, quantitative analysis of the profile of patients with diabetes mellitus who in 2006 underwent amputation of limbs at a public university hospital. Data were collected from patient medical records, after approval by the Bioethics Committee of the hospital. The results showed that of the 92 patients who underwent amputation, 32% were diabetic. The patients' ages ranged between 46 and 89 years, and 52% were male. It was found that 93% of patients had diabetic neuropathy, 93% had lower limb ulcers, 52% had gangrene. They remained hospitalized an average of 14 days, and the length of hospital stay varied from 3 to 50 days. Of the amputations performed, 30% involved the thigh, 30% toes, 27.50% upper third of the leg, 5% transmetatarsal region, 5% knee disarticulation and 2.5% calcaneus bone. The increase in amputations is cause for concern for the quality of life of these patients, considering the physical and psychological impact that amputation has on the individual. Furthermore, higher government and institutional costs will be required to assist the health needs of these patients. It was concluded that prevention is the best alternative to reduce this amputation rate and improve the quality of life of diabetics.

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil)

“…With regard to length of hospital stay, this varies according to the type of amputation (traumatic or non-traumatic), patient age, postoperative complications, and hospital logistics, among other factors. In a study by Senefonte et al, 5 mean length of hospital stay was 23.7±7.8 days, contrasting with a study by Bortoletto et al, 24 in which length of hospital stay ranged from 3 to 50 days. Nevertheless, in studies such as one by Oliveira et al, 25 the length of hospital stays of amputated patients ranged from 7 to 157 days, similar to in this study.…”

Pé Diabético: Perfil Sociodemográfico e Clínico de Pacientes Hospitalizados

“…No entanto, a insulinoterapia teve um alto índice de uso quando comparado a outras pesquisas 17,23 . O controle glicêmico inadequado predispõe ao surgimento de complicações crônicas, que se iniciam por volta do quinto ano de instalação do DM 26 . A neuropatia e a vasculopatia, principais causas do pé diabético, têm sido os acometimentos mais frequentemente demonstrados na literatura 21,27,28 .…”

Evidências para a avaliação dos pés da pessoa com diabetes mellitus

“…Protective and Tactile Sensitivity (9) Semmes-Weinstein monofilament stereo meter 10g, cotton balls Thermal sensitivity (4) test tubes with cold and hot water Pain sensitivity (3) pins Vibration Sensitivity (5) biotensiometer, tuning fork 128 Hz Patellar reflex (1) reflex hammer Tendon reflex (1) reflex hammer Scores of neuropathic symptoms: pain or discomfort, sensory and locational symptoms, time and improvement of symptoms (4)…”

“…The association of risk factors, such as peripheral neuropathy and peripheral vascular disease, predisposes to the appearance of this recurrent complication in the diabetic population and of complex clinical handling. [1][2] Injuries to the lower limbs are more commonly seen in people with MD compared to non-diabetics and reach 6.4% of the world's population, increasing ten to twenty times the chances of progressing to amputation.…”