Arch Plast Surg.  2017 Nov;44(6):539-544. 10.5999/aps.2017.01207.

Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

• Choi SK
• Kim CK
• Jo DI
• Lee MC
• Kim JN
• Choi HG
• Shin DH
• Kim SH

• KMID: 2403956
• DOI: http://doi.org/10.5999/aps.2017.01207

Abstract

BACKGROUND
We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting.
METHODS
In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels.
RESULTS
Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P < 0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046-0.356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113-3.673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020).
CONCLUSIONS
Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

Keyword

Diabetes mellitus; Diabetic foot; Length of stay; Prognosis; Limb salvage

MeSH Terms

Blood Glucose
Blood Sedimentation
Body Mass Index
C-Reactive Protein
Comorbidity
Diabetes Mellitus
Diabetic Foot*
Hemoglobin A, Glycosylated
Humans
Hypertension
Length of Stay*
Leukocytes
Limb Salvage
Prognosis
Retrospective Studies*
Smoke
Smoking
Surgeons
Wounds and Injuries
Blood Glucose
C-Reactive Protein
Smoke