Clinical outcomes among patients with chronic kidney disease hospitalized with diabetic foot disorders: A nationwide retrospective study.
amputation
chronic kidney disease
diabetic foot infection
diabetic foot ulcer
dialysis
end‐stage renal disease
Journal
Endocrinology, diabetes & metabolism
ISSN: 2398-9238
Titre abrégé: Endocrinol Diabetes Metab
Pays: England
ID NLM: 101732442
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
16
04
2021
revised:
18
05
2021
accepted:
22
05
2021
entrez:
19
7
2021
pubmed:
20
7
2021
medline:
15
3
2022
Statut:
epublish
Résumé
Diabetic foot ulcerations or infections (DFUs/DFIs) are common complications of patients with diabetes. This study aimed to explore the impact of non-dialysis and dialysis CKD on hospitalized patients with DFUs/DFIs. A retrospective cohort study was conducted using the National Inpatient Sample database for the years 2017 and 2018. Patients hospitalized for DFUs/DFIs were included in the study. The primary outcome was lower limb amputations. The secondary outcomes were inpatient mortality, sepsis, length of stay (LOS), total hospitalization charges (THC) and disposition. A total of 121,815 hospitalizations were included (26.1% non-dialysis CKD; 8.4% dialysis CKD). There was no significant difference in amputation rates between those on non-dialysis CKD (adjusted odds ratio [aOR]: 0.96; 95% confidence interval [CI]: 0.87-1.06) and dialysis CKD (aOR: 1.04, [95% CI: 0.91-1.12]) when compared to non-CKD group. Dialysis CKD group had increased odds of undergoing major amputation (aOR: 1.74, [95% CI: 1.32-2.29]), in-hospital mortality (aOR: 3.77 [95% CI: 1.94-7.31]), sepsis (aOR: 1.83 [95% CI: 1.27-2.62]), longer LOS (adjusted mean difference [aMD]: 1.46 [95 CI: 1.12-1.80) and higher THC (adjusted mean difference [aMD]: $20,148 [95% CI: $15,968-$24,327]). Non-dialysis CKD group had increased odds of sepsis (aOR: 1.36 [95% CI: 1.02-1.82]), less likely to be discharged home (aOR: 0.87 [95% CI: 0.80-0.95]), longer LOS (aMD: 0.91 [95% CI 0.69-1.13]) and higher THC (aMD: $20,148 [95% CI: $15,968-$24,327]). Patients with CKD on dialysis had higher odds of undergoing major amputation. CKD increased the odds of in-hospital morbidity and resource utilization, with the most significant is for those on dialysis.
Identifiants
pubmed: 34277993
doi: 10.1002/edm2.277
pii: EDM2277
pmc: PMC8279616
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e00277Informations de copyright
© 2021 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
Déclaration de conflit d'intérêts
The author reports no conflicts of interest in this work.
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