Clinical outcomes among patients with chronic kidney disease hospitalized with diabetic foot disorders: A nationwide retrospective study.
Endocrinol Diabetes Metab
; 4(3): e00277, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-34277993
ABSTRACT
INTRODUCTION:
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.METHODS:
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.RESULTS:
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]).CONCLUSION:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pé Diabético
/
Diabetes Mellitus
/
Insuficiência Renal Crônica
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article