Length of stay and readmissions for people with diabetes-related foot ulceration admitted to two public tertiary referral hospitals in Australia

Aims/hypothesis To identify hospital admissions and length of stay (LOS) and to investigate readmissions, cumulative LOS and associated factors for diabetes-related foot ulceration (DFU). Methods Routinely-collected hospital admission data were used to identify DFU-related hospital admissions in two public hospitals between 2012-17. Readmission and cumulative LOS were investigated using negative binomial regression. Results DFU-related admission was required by 749 patients. Median LOS was 8-10 days (stable across 2012-17). Readmission within 28 days was required by 62 patients (8%) and was significantly more likely with increasing comorbidities (incidence rate ratio [IRR] 1.38, 95% confidence intervals [95% CI] 1.02-1.88). Readmission within 1 year was required by 206 patients (28%), and was significantly more likely for males, unplanned admissions and increasing revascularisation requirements (IRR 1.34-1.70), and significantly less likely for those requiring minor and major amputation (IRR 0.33-0.64). The median cumulative LOS was 13 days (IQR 7-29), and was significantly longer for males, older age, unplanned admissions, those requiring dialysis, and those with increasing revascularisation requirements, comorbidities and mental health or behavioural disorders (IRR 1.02-2.30), and significantly shorter for those with more podiatry attendance (IRR 0.96, 95% CI 0.95-0.97). Conclusions/interpretation Results provide an important benchmark for DFU outcomes. Predictors for patients at risk of readmission and prolonged cumulative LOS were identified which may be used to guide intervention.