Choi Sang Kyu, Kim Cheol Keun, Jo Dong In, Lee Myung Chul, Kim Jee Nam, Choi Hyun Gon, Shin Dong Hyeok, Kim Soon Heum
Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Chungju, Korea.
Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea.
Arch Plast Surg. 2017 Nov;44(6):539-544. doi: 10.5999/aps.2017.01207. Epub 2017 Nov 10.
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.
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.
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).
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.
我们开展这项研究以确定在单一机构环境中可能延长糖尿病足(DF)患者住院时间(LHS)的因素。
在这项单中心回顾性研究中,我们共评估了164例DF患者,并对他们的基线人口统计学和临床特征进行了组间比较,包括性别、年龄、糖尿病病程、吸烟状况、体重指数、基础合并症(如高血压或糖尿病肾病)、伤口特征、手术类型、总医疗费用、白细胞(WBC)计数、C反应蛋白(CRP)水平、红细胞沉降率以及白蛋白、蛋白质、糖化血红蛋白和7天平均血糖(BG)水平。
Pearson相关性分析显示,住院时间>5周与伤口严重程度(r = 0.647)、白细胞计数(r = 0.571)、CRP水平(r = 0.390)、糖尿病肾病(r = 0.020)和7天平均血糖水平(r = 0.120)呈显著正相关(P<0.05)。在多元回归分析中,住院时间>5周与伤口严重程度(比值比[OR]=3.297;95%置信区间[CI],1.324 - 10.483;P = 0.020)、白细胞计数(OR = 1.423;95% CI,0.046 - 0.356;P = 0.000)、CRP水平(OR = 1.079;95% CI,1.015 - 1.147;P = 0.014)、白蛋白水平(OR = 0.263;95% CI,0.113 - 3.673;P = 0.007)和7天平均血糖水平(OR = 1.018;95% CI,1.001 - 1.035;P = 0.020)呈显著正相关。
外科医生在DF患者的早期管理中应考虑与延长住院时间相关的因素。此外,还应采用多学科方法来缩短住院时间。