INTRODUCTION
Diabetes-related foot complications are a major health problem often resulting in significant morbidity and mortality. Data around readmissions in this population, although limited, show patients who present with one diabetic foot problem often present again. Such data resulted in unplanned readmission rates of up to 40% for diabetic foot infection.1
OBJECTIVE
To determine the rate and factors associated with readmission in a dedicated Diabetic Foot Unit (DFU).
METHODS
A retrospective review of all DFU patients admitted between January 2015 and December 2016 at a tertiary referral centre was conducted. Demographics and clinical characteristics were collected and analysed between patients readmitted within 6 weeks of discharge and those who were not.
RESULTS
340 patients were included in the study, with a readmission rate of 15.6% (n=53). 70% (n=42) of readmissions were unplanned. Within the first week of discharge, 40.5% of these unplanned readmissions occurred. More than half of readmissions were related to infection (53.3%), followed by failure of wound healing (6.7%) and ischaemia (3.3%). 43% of readmissions had a history of amputation compared to 28% in the non-readmission group. A greater proportion of wounds were in the forefoot for readmitted patients (81.7% vs 65.6%). 54.8% of unplanned readmissions had an amputation during their index admission.
CONCLUSION
To our knowledge, this is the first dedicated DFU audit looking at readmission rates. Readmissions occurred in 15.6%, majority (70%) are unplanned and occurred most frequently in the first week post discharge. Most common cause for readmission was infection, with a small proportion secondary to failure of wound healing. Factors contributing to readmission include forefoot wounds and history of amputation.