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Arch Plast Surg > Volume 44(6); 2017 > Article
Archives of Plastic Surgery 2017;44(6):539-544.
DOI: https://doi.org/10.5999/aps.2017.01207    Published online November 10, 2017.
Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study
Sang Kyu Choi1, Cheol Keun Kim1, Dong In Jo1, Myung Chul Lee2, Jee Nam Kim2, Hyun Gon Choi2, Dong Hyeok Shin2, Soon Heum Kim1
1Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Chungju, Korea
2Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea
Correspondence:  Soon Heum Kim, Tel: +82-43-840-8860, Fax: +82-43-840-9862, 
Email: plastic7@kku.ac.kr
Received: 18 July 2017   • Revised: 11 October 2017   • Accepted: 31 October 2017
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.
Keywords: Diabetes mellitus / Diabetic foot / Length of stay / Prognosis / Limb salvage
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