An Investigation of the Factors Affecting the Length of Hospitalization of Diabetic Foot Patients Who Underwent Minor Amputation

TL;DR

This study identifies factors influencing hospital stay length in diabetic foot patients who had minor amputations.

Contribution

The study identifies specific clinical and rehabilitative factors that significantly affect hospitalization duration after minor amputation in diabetic foot patients.

Findings

The load reduction period significantly correlates with hospital stay duration.

Intensive early rehabilitation is associated with shorter hospitalization.

The level of amputation and cognitive status (HDS-R) also influence hospital stay length.

Abstract

Background

While progress in multidisciplinary therapies has substantially improved the limb-sparing rate of patients with diabetic foot or peripheral artery disorders, the requirement for multiple resting periods for the recovery of foot disorders has resulted in prolonged hospitalization. This study aimed to determine the factors that significantly affect the length of hospital stay in patients with diabetic foot who underwent minor amputation.

Methodology

This study included 95 patients with diabetic foot who underwent minor amputation followed by rehabilitation between April 2013 and June 2016. We retrospectively evaluated the factors available in the medical records. The factors included age, sex, body mass index, level of amputation, presence of hemodialysis, preoperative weight bearing index, motor ability, discharge destination, load reduction period, Barthel index, Hasegawa Dementia Scale-Revised (HDS-R), preoperative blood tests (C-reactive protein and serum albumin), and average number of units of rehabilitation. Spearman’s rank correlation coefficient and multiple regression analysis were used for statistical analysis.

Results

Multiple factors, including load reduction period, HDS-R, average number of units of rehabilitation provided, and the level of amputation, were significantly correlated with the duration of hospital stay.

Conclusions

Shortening the load reduction period and intensive rehabilitation at an early stage after amputation should be prioritized to minimize hospitalization in patients with diabetic feet.

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