Archives of Plastic Surgery  2017;44(6):539-544

doi:10.5999/aps.2017.01207

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

Sang Kyu CHOI 1 ; Cheol Keun KIM ; Dong In JO ; Myung Chul LEE ; Jee Nam KIM ; Hyun Gon CHOI ; Dong Hyeok SHIN ; Soon Heum KIM

Affiliations

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Keywords

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

Country

Republic of Korea

Language

English

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.