Length of stay and readmissions for people with diabetes-related foot ulceration

admitted to two public tertiary referral hospitals in Australia

 

Sarah M Manewell, Sarah J Aitken, Vanessa L Nube, Anna M Crawford, Maria I Constantino, Stephen M Twigg, Hylton B Menz, Cathie Sherrington and Serene S Paul

 

Aims/hypothesis To identify hospital admissions and length of stay (LOS) and to investigate readmissions, cumulative LOS and associated factors for diabetes-related foot ulceration (DFU).

Methods Routinely-collected hospital admission data were used to identify DFU-related hospital admissions in two public hospitals between 2012–17. Readmission and cumulative LOS were investigated using negative binomial regression.

Results DFU-related admission was required by 749 patients. Median LOS was 8–10 days (stable across 2012–17). Readmission within 28 days was required by 62 patients (8%) and was significantly more likely with increasing comorbidities (incidence rate ratio [IRR] 1.38, 95% confidence intervals [95% CI] 1.02–1.88). Readmission within 1 year was required by 206 patients (28%), and was significantly more likely for males, unplanned admissions and increasing revascularisation requirements (IRR 1.34–1.70), and significantly less likely for those requiring minor and major amputation (IRR 0.33–0.64). The median cumulative LOS was 13 days (IQR 7–29), and was significantly longer for males, older age, unplanned admissions, those requiring dialysis, and those with increasing revascularisation requirements, comorbidities and mental health or behavioural disorders (IRR 1.02–2.30), and significantly shorter for those with more podiatry attendance (IRR 0.96, 95% CI 0.95–0.97) … read more