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Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis
Background/Aims Lower limb (LL) cellulitis‐related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions. Methods A retrospective case‐control study at an urban hospital servicing a multi‐ethnic population in New Z...
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| Published in: | Internal medicine journal 2017-01, Vol.47 (1), p.82-88 |
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| container_end_page | 88 |
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| container_start_page | 82 |
| container_title | Internal medicine journal |
| container_volume | 47 |
| creator | Wijayaratna, S. M. Cundy, T. Drury, P. L. Sehgal, S. Wijayaratna, S. A. Wu, F. |
| description | Background/Aims
Lower limb (LL) cellulitis‐related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions.
Methods
A retrospective case‐control study at an urban hospital servicing a multi‐ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with LL cellulitis in 2008–2013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions. Glycaemic control was assessed by HbA1c measured within 6 months of the index admission.
Results
There were 4600 admissions with LL cellulitis in 3636 patients, including 719 patients (20%) with type 2 diabetes. Hospital stay was longer for type 2 diabetes patients (median 5.3 vs 3.0 days, P |
| doi_str_mv | 10.1111/imj.13299 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868315119</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1920487530</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3869-29c3c1c89be1fadbfb6a600fd9bcaf3a33b655bdfb0ff50f2d3bf09a499913f03</originalsourceid><addsrcrecordid>eNqNkc1q3DAURkVpaNK0i7xAEHSTLpxIlu3xXYYhbRMSumnXQr-NBtlyJJlh9n3wyplpF4FCtJEuOhzdqw-hM0ouaVlXbthcUlYDvEEntGnaqgVo3j6fm4oAYcfofUobQuiKQfMOHderVQOlPEG_r1MKyonswoiDxXk3GVxj7YQ02SS8dfkRTzH4MP4yGj-GNLksPE5Z7LAYNXajikakchdFNouilHpwKS1GN-KpuM2YDyoftiZi7waJlfF-9i679AEdWeGT-XjYT9HPLzc_1t-q--9fb9fX95VifQdVDYopqnqQhlqhpZWd6AixGqQSlgnGZNe2UltJrG2JrTWTloBoAIAyS9gputh7y0BPs0mZlz6XNsRowpw47bue0ZZSeAXK2vK7HekL-ukFuglzHMsgnEJNmn7VsuXtz3tKxZBSNJZP0Q0i7jglfEmRlxT5c4qFPT8YZzkY_Y_8G1sBrvbA1nmz-7-J3z7c7ZV_AIwfqKw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1920487530</pqid></control><display><type>article</type><title>Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis</title><source>Wiley</source><creator>Wijayaratna, S. M. ; Cundy, T. ; Drury, P. L. ; Sehgal, S. ; Wijayaratna, S. A. ; Wu, F.</creator><creatorcontrib>Wijayaratna, S. M. ; Cundy, T. ; Drury, P. L. ; Sehgal, S. ; Wijayaratna, S. A. ; Wu, F.</creatorcontrib><description>Background/Aims
Lower limb (LL) cellulitis‐related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions.
Methods
A retrospective case‐control study at an urban hospital servicing a multi‐ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with LL cellulitis in 2008–2013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions. Glycaemic control was assessed by HbA1c measured within 6 months of the index admission.
Results
There were 4600 admissions with LL cellulitis in 3636 patients, including 719 patients (20%) with type 2 diabetes. Hospital stay was longer for type 2 diabetes patients (median 5.3 vs 3.0 days, P < 0.001), independent of age, ethnicity and HbA1c. Accompanying LL ulceration was more frequent in type 2 diabetes patients (50% vs 17%, P < 0.001); however, admissions remained longer for type 2 diabetes patients without ulceration (median 3.4 vs 2.8 days, P < 0.001). Readmission rates were also higher in type 2 diabetes patients compared to non‐diabetes patients (HR 1.7, P < 0.001), even in the absence of ulceration (HR 2.2, P < 0.001). Age, HbA1c and ethnicity did not distinguish those prone to readmissions in the type 2 diabetes cohort. Type 2 diabetes patients accounted for a fifth of all admissions and one third of the estimated costs.
Conclusions
A high proportion of patients with type 2 diabetes was admitted with LL cellulitis. They had significantly longer admissions and higher readmission rates. Age, HbA1c and ethnicity did not predict length of stay or recurrence.</description><identifier>ISSN: 1444-0903</identifier><identifier>EISSN: 1445-5994</identifier><identifier>DOI: 10.1111/imj.13299</identifier><identifier>PMID: 27749001</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Adult ; Age ; Aged ; Aged, 80 and over ; Amputation - statistics & numerical data ; Case-Control Studies ; Cellulitis ; Cellulitis - epidemiology ; Diabetes ; diabetes complications ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - complications ; Ethnicity ; Female ; hospitalisations ; Humans ; Length of Stay - statistics & numerical data ; Logistic Models ; Lower Extremity - physiopathology ; lower limb cellulitis ; Male ; Middle Aged ; Minority & ethnic groups ; New Zealand ; Patient Readmission - statistics & numerical data ; readmissions ; Retrospective Studies ; Risk Factors ; type 2 diabetes</subject><ispartof>Internal medicine journal, 2017-01, Vol.47 (1), p.82-88</ispartof><rights>2016 Royal Australasian College of Physicians</rights><rights>2016 Royal Australasian College of Physicians.</rights><rights>2017 Royal Australasian College of Physicians</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3869-29c3c1c89be1fadbfb6a600fd9bcaf3a33b655bdfb0ff50f2d3bf09a499913f03</citedby><cites>FETCH-LOGICAL-c3869-29c3c1c89be1fadbfb6a600fd9bcaf3a33b655bdfb0ff50f2d3bf09a499913f03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27749001$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wijayaratna, S. M.</creatorcontrib><creatorcontrib>Cundy, T.</creatorcontrib><creatorcontrib>Drury, P. L.</creatorcontrib><creatorcontrib>Sehgal, S.</creatorcontrib><creatorcontrib>Wijayaratna, S. A.</creatorcontrib><creatorcontrib>Wu, F.</creatorcontrib><title>Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis</title><title>Internal medicine journal</title><addtitle>Intern Med J</addtitle><description>Background/Aims
Lower limb (LL) cellulitis‐related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions.
Methods
A retrospective case‐control study at an urban hospital servicing a multi‐ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with LL cellulitis in 2008–2013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions. Glycaemic control was assessed by HbA1c measured within 6 months of the index admission.
Results
There were 4600 admissions with LL cellulitis in 3636 patients, including 719 patients (20%) with type 2 diabetes. Hospital stay was longer for type 2 diabetes patients (median 5.3 vs 3.0 days, P < 0.001), independent of age, ethnicity and HbA1c. Accompanying LL ulceration was more frequent in type 2 diabetes patients (50% vs 17%, P < 0.001); however, admissions remained longer for type 2 diabetes patients without ulceration (median 3.4 vs 2.8 days, P < 0.001). Readmission rates were also higher in type 2 diabetes patients compared to non‐diabetes patients (HR 1.7, P < 0.001), even in the absence of ulceration (HR 2.2, P < 0.001). Age, HbA1c and ethnicity did not distinguish those prone to readmissions in the type 2 diabetes cohort. Type 2 diabetes patients accounted for a fifth of all admissions and one third of the estimated costs.
Conclusions
A high proportion of patients with type 2 diabetes was admitted with LL cellulitis. They had significantly longer admissions and higher readmission rates. Age, HbA1c and ethnicity did not predict length of stay or recurrence.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amputation - statistics & numerical data</subject><subject>Case-Control Studies</subject><subject>Cellulitis</subject><subject>Cellulitis - epidemiology</subject><subject>Diabetes</subject><subject>diabetes complications</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Ethnicity</subject><subject>Female</subject><subject>hospitalisations</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Lower Extremity - physiopathology</subject><subject>lower limb cellulitis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>New Zealand</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>readmissions</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>type 2 diabetes</subject><issn>1444-0903</issn><issn>1445-5994</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkc1q3DAURkVpaNK0i7xAEHSTLpxIlu3xXYYhbRMSumnXQr-NBtlyJJlh9n3wyplpF4FCtJEuOhzdqw-hM0ouaVlXbthcUlYDvEEntGnaqgVo3j6fm4oAYcfofUobQuiKQfMOHderVQOlPEG_r1MKyonswoiDxXk3GVxj7YQ02SS8dfkRTzH4MP4yGj-GNLksPE5Z7LAYNXajikakchdFNouilHpwKS1GN-KpuM2YDyoftiZi7waJlfF-9i679AEdWeGT-XjYT9HPLzc_1t-q--9fb9fX95VifQdVDYopqnqQhlqhpZWd6AixGqQSlgnGZNe2UltJrG2JrTWTloBoAIAyS9gputh7y0BPs0mZlz6XNsRowpw47bue0ZZSeAXK2vK7HekL-ukFuglzHMsgnEJNmn7VsuXtz3tKxZBSNJZP0Q0i7jglfEmRlxT5c4qFPT8YZzkY_Y_8G1sBrvbA1nmz-7-J3z7c7ZV_AIwfqKw</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Wijayaratna, S. M.</creator><creator>Cundy, T.</creator><creator>Drury, P. L.</creator><creator>Sehgal, S.</creator><creator>Wijayaratna, S. A.</creator><creator>Wu, F.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201701</creationdate><title>Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis</title><author>Wijayaratna, S. M. ; Cundy, T. ; Drury, P. L. ; Sehgal, S. ; Wijayaratna, S. A. ; Wu, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3869-29c3c1c89be1fadbfb6a600fd9bcaf3a33b655bdfb0ff50f2d3bf09a499913f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amputation - statistics & numerical data</topic><topic>Case-Control Studies</topic><topic>Cellulitis</topic><topic>Cellulitis - epidemiology</topic><topic>Diabetes</topic><topic>diabetes complications</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Ethnicity</topic><topic>Female</topic><topic>hospitalisations</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Logistic Models</topic><topic>Lower Extremity - physiopathology</topic><topic>lower limb cellulitis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minority & ethnic groups</topic><topic>New Zealand</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>readmissions</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wijayaratna, S. M.</creatorcontrib><creatorcontrib>Cundy, T.</creatorcontrib><creatorcontrib>Drury, P. L.</creatorcontrib><creatorcontrib>Sehgal, S.</creatorcontrib><creatorcontrib>Wijayaratna, S. A.</creatorcontrib><creatorcontrib>Wu, F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Internal medicine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wijayaratna, S. M.</au><au>Cundy, T.</au><au>Drury, P. L.</au><au>Sehgal, S.</au><au>Wijayaratna, S. A.</au><au>Wu, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis</atitle><jtitle>Internal medicine journal</jtitle><addtitle>Intern Med J</addtitle><date>2017-01</date><risdate>2017</risdate><volume>47</volume><issue>1</issue><spage>82</spage><epage>88</epage><pages>82-88</pages><issn>1444-0903</issn><eissn>1445-5994</eissn><abstract>Background/Aims
Lower limb (LL) cellulitis‐related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions.
Methods
A retrospective case‐control study at an urban hospital servicing a multi‐ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with LL cellulitis in 2008–2013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions. Glycaemic control was assessed by HbA1c measured within 6 months of the index admission.
Results
There were 4600 admissions with LL cellulitis in 3636 patients, including 719 patients (20%) with type 2 diabetes. Hospital stay was longer for type 2 diabetes patients (median 5.3 vs 3.0 days, P < 0.001), independent of age, ethnicity and HbA1c. Accompanying LL ulceration was more frequent in type 2 diabetes patients (50% vs 17%, P < 0.001); however, admissions remained longer for type 2 diabetes patients without ulceration (median 3.4 vs 2.8 days, P < 0.001). Readmission rates were also higher in type 2 diabetes patients compared to non‐diabetes patients (HR 1.7, P < 0.001), even in the absence of ulceration (HR 2.2, P < 0.001). Age, HbA1c and ethnicity did not distinguish those prone to readmissions in the type 2 diabetes cohort. Type 2 diabetes patients accounted for a fifth of all admissions and one third of the estimated costs.
Conclusions
A high proportion of patients with type 2 diabetes was admitted with LL cellulitis. They had significantly longer admissions and higher readmission rates. Age, HbA1c and ethnicity did not predict length of stay or recurrence.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>27749001</pmid><doi>10.1111/imj.13299</doi><tpages>1</tpages></addata></record> |
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| subjects | Adult Age Aged Aged, 80 and over Amputation - statistics & numerical data Case-Control Studies Cellulitis Cellulitis - epidemiology Diabetes diabetes complications Diabetes mellitus Diabetes Mellitus, Type 2 - complications Ethnicity Female hospitalisations Humans Length of Stay - statistics & numerical data Logistic Models Lower Extremity - physiopathology lower limb cellulitis Male Middle Aged Minority & ethnic groups New Zealand Patient Readmission - statistics & numerical data readmissions Retrospective Studies Risk Factors type 2 diabetes |
| title | Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis |
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