J Korean Med Sci.  2016 Jan;31(1):120-124. 10.3346/jkms.2016.31.1.120.

Factors Affecting Length of Hospital Stay and Mortality in Infected Diabetic Foot Ulcers Undergoing Surgical Drainage without Major Amputation

• Kim TG
• Moon SY
• Park MS
• Kwon SS
• Jung KJ
• Lee T
• Kim BK
• Yoon C
• Lee KM

• KMID: 2360001
• DOI: http://doi.org/10.3346/jkms.2016.31.1.120

Abstract

This study aimed to investigate factors affecting length of hospital stay and mortality of a specific group of patients with infected diabetic foot ulcer who underwent surgical drainage without major amputation, which is frequently encountered by orthopedic surgeons. Data on length of hospital stay, mortality, demographics, and other medical information were collected for 79 consecutive patients (60 men, 19 women; mean age, 66.1 [SD, 12.3] yr) with infected diabetic foot ulcer who underwent surgical drainage while retaining the heel between October 2003 and May 2013. Multiple linear regression analysis was performed to determine factors affecting length of hospital stay, while multiple Cox regression analysis was conducted to assess factors contributing to mortality. Erythrocyte sedimentation rate (ESR, P=0.034), glycated hemoglobin (HbA1c) level (P=0.021), body mass index (BMI, P=0.001), and major vascular disease (cerebrovascular accident or coronary artery disease, P=0.004) were significant factors affecting length of hospital stay, whereas age (P=0.005) and serum blood urea nitrogen (BUN) level (P=0.024) were significant factors contributing to mortality. In conclusion, as prognostic factors, the length of hospital stay was affected by the severity of inflammation, the recent control of blood glucose level, BMI, and major vascular disease, whereas patient mortality was affected by age and renal function in patients with infected diabetic foot ulcer undergoing surgical drainage and antibiotic treatment.

Keyword

Diabetic Foot; Foot Ulcer; Length of Stay; Mortality

MeSH Terms

Aged
Amputation
Blood Sedimentation
Blood Urea Nitrogen
Body Mass Index
Diabetic Foot/mortality/*pathology/*surgery
Drainage
Female
Hemoglobin A, Glycosylated/analysis
Humans
Length of Stay
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Vascular Diseases/complications
Hemoglobin A, Glycosylated

Figure

• 

  Fig. 1 This flowchart shows the strategy to identify patients with infected diabetic foot ulcers who require surgical drainage.

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