Abstract：
BACKGROUND: Diabetic foot (DF) is part of the natural history of diabetes mellitus, ulceration being a severe complication with a prevalence of approximately 6.3 %, which confers a significant economic burden. Hospital readmission in the first thirty (30) days is considered a measure of quality of healthcare and it\'s been identified that the most preventable causes are the ones that occur in this period. This study seeks to identify the risk factors associated with readmission of patients with DF.
METHODS: A case-control study was done by performing a secondary analysis of a database. Descriptive statistics were used for all variables of interest, bivariate analysis to identify statistically significant variables, and a logistic regression model for multivariate analysis.
RESULTS: 575 cases were analyzed (113 cases, 462 controls). A 20 % incidence rate of 30-day readmission was identified. Statistically significant differences were found in relation to the institution of attention (Hospital Universitario de la Samaritana: OR 1.9, p value < 0.01, 95 % CI 1.2-3.0; Hospital Universitario San Ignacio: OR 0.5, p value < 0.01, 95 % CI 0.3-0.8) and the reasons for readmission before 30 days, especially due to surgical site infection (SSI) (OR 7.1, p value < 0.01, 95 % CI 4.1-12.4), sepsis (OR 8.4, p value 0.02, 95 % CI 1.2-94.0), dehiscence in amputation stump (OR 16.4, p value < 0.01, 95 % CI 4.2-93.1) and decompensation of other pathologies (OR 3.5, p value < 0.01, 95 % CI 2.1-5.7).
CONCLUSIONS: The hospital readmission rate before 30 days for our population compares to current literature. Our results were consistent with exacerbation of chronic pathologies, but other relevant variables not mentioned in other studies were the hospital in which patients were taken care of, the presence of SSI, sepsis, and dehiscence of the amputation stump. We consider thoughtful and close screening of patients at risk in an outpatient setting might identify possible readmissions.
METHODS: A case-control study was done by performing a secondary analysis of a database. Descriptive statistics were used for all variables of interest, bivariate analysis to identify statistically significant variables, and a logistic regression model for multivariate analysis.
RESULTS: 575 cases were analyzed (113 cases, 462 controls). A 20 % incidence rate of 30-day readmission was identified. Statistically significant differences were found in relation to the institution of attention (Hospital Universitario de la Samaritana: OR 1.9, p value < 0.01, 95 % CI 1.2-3.0; Hospital Universitario San Ignacio: OR 0.5, p value < 0.01, 95 % CI 0.3-0.8) and the reasons for readmission before 30 days, especially due to surgical site infection (SSI) (OR 7.1, p value < 0.01, 95 % CI 4.1-12.4), sepsis (OR 8.4, p value 0.02, 95 % CI 1.2-94.0), dehiscence in amputation stump (OR 16.4, p value < 0.01, 95 % CI 4.2-93.1) and decompensation of other pathologies (OR 3.5, p value < 0.01, 95 % CI 2.1-5.7).
CONCLUSIONS: The hospital readmission rate before 30 days for our population compares to current literature. Our results were consistent with exacerbation of chronic pathologies, but other relevant variables not mentioned in other studies were the hospital in which patients were taken care of, the presence of SSI, sepsis, and dehiscence of the amputation stump. We consider thoughtful and close screening of patients at risk in an outpatient setting might identify possible readmissions.
摘要：
背景：糖尿病足（DF）是糖尿病自然史的一部分，溃疡是一种严重的并发症，患病率约为6.3%，这造成了巨大的经济负担。在前三十（30）天的再入院被认为是衡量医疗保健质量的指标，并且已经确定，最可预防的原因是在此期间发生的原因。本研究旨在确定与DF患者再入院相关的危险因素。
方法：通过对数据库进行二次分析，完成了一项病例对照研究。描述性统计用于所有感兴趣的变量，双变量分析，以确定具有统计学意义的变量，和多变量分析的逻辑回归模型。
结果：575例（113例，462个控件）。确定30天再入院的发生率为20％。在关注机构方面发现了统计学上的显着差异（撒玛利亚塔纳大学医院：OR1.9，p值<0.01，95％CI1.2-3.0；圣伊格纳西奥大学医院：OR0.5，p值<0.01，95％CI0.3-0.8）以及30天之前再次入院的原因，特别是由于手术部位感染（SSI）（OR7.1，p值<0.01，95％CI4.1-12.4），脓毒症（OR8.4，p值0.02，95%CI1.2-94.0），截肢残端开裂（OR16.4，p值<0.01，95％CI4.2-93.1）和其他病变代偿失调（OR3.5，p值<0.01，95％CI2.1-5.7）。
结论：我们人群30天之前的再入院率与现有文献相比。我们的结果与慢性病变的恶化一致，但是其他研究中没有提到的其他相关变量是照顾患者的医院，SSI的存在，脓毒症,截肢残肢的裂开.我们认为，在门诊环境中对有风险的患者进行周到和密切的筛查可能会确定可能的再入院。
方法：通过对数据库进行二次分析，完成了一项病例对照研究。描述性统计用于所有感兴趣的变量，双变量分析，以确定具有统计学意义的变量，和多变量分析的逻辑回归模型。
结果：575例（113例，462个控件）。确定30天再入院的发生率为20％。在关注机构方面发现了统计学上的显着差异（撒玛利亚塔纳大学医院：OR1.9，p值<0.01，95％CI1.2-3.0；圣伊格纳西奥大学医院：OR0.5，p值<0.01，95％CI0.3-0.8）以及30天之前再次入院的原因，特别是由于手术部位感染（SSI）（OR7.1，p值<0.01，95％CI4.1-12.4），脓毒症（OR8.4，p值0.02，95%CI1.2-94.0），截肢残端开裂（OR16.4，p值<0.01，95％CI4.2-93.1）和其他病变代偿失调（OR3.5，p值<0.01，95％CI2.1-5.7）。
结论：我们人群30天之前的再入院率与现有文献相比。我们的结果与慢性病变的恶化一致，但是其他研究中没有提到的其他相关变量是照顾患者的医院，SSI的存在，脓毒症,截肢残肢的裂开.我们认为，在门诊环境中对有风险的患者进行周到和密切的筛查可能会确定可能的再入院。
