{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T16:35:51Z","timestamp":1773160551142,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T00:00:00Z","timestamp":1538611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012306","name":"Center for Innovative Medicine, Johns Hopkins University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1R25HL126145\u201001"],"award-info":[{"award-number":["1R25HL126145\u201001"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The aim of the study is to investigate effects of morbid obesity on patients hospitalized with diabetic foot ulcers and infections (DFU\/Is). This retrospective cohort study of hospitalized adults investigated patients with a principal diagnosis of DFU\/Is, and compared outcomes based on weight. The primary outcome was lower limb amputations. Secondary outcomes included in\u2010hospital mortality, morbidity (sepsis and discharge disposition), resource utilization (length of stay [LOS] and total hospitalization charges). Multivariate analyses adjusted for confounders. A total of 31 730 admissions were included; 14% were morbidly obese. Patients with morbid obesity had overall lower rates of amputations (adjusted odds ratio [aOR]: 0.60; 95% confidence interval [CI]: 0.45\u20130.80). There was no difference in mortality rates between those who were morbidly obese and the non\u2010morbidly obese patients (aOR: 3.89 [95% CI: 0.79\u201319.30]). Combined data from 2010 to 2014 have found higher odds of sepsis in morbidly obese patients compared with non\u2010morbidly obese patients after adjusting for confounders (aOR: 1.49 [1.09\u20132.02], <jats:italic>P<\/jats:italic> = 0.01). Patients with morbid obesity were less likely to be discharged to home (aOR: 0.82 [95% CI: 0.70\u20130.95]), had longer LOS (adjusted mean difference [aMD]: 0.47 [95% CI: 0.13\u20130.81]) and higher hospital charges (aMD: $3205 [95% CI: $3373\u2013$6037]). Despite having lower amputation rates compared to those who are not morbidly obese, patients with morbid obesity hospitalized for DFU\/Is succumbed to sepsis more frequently and had less favourable utilization metrics. Specialized care pathways may be needed to enhance the value of care delivered to this high\u2010risk population.<\/jats:p>","DOI":"10.1111\/cob.12285","type":"journal-article","created":{"date-parts":[[2018,10,6]],"date-time":"2018-10-06T02:52:37Z","timestamp":1538794357000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical outcomes among morbidly obese patients hospitalized with diabetic foot complications"],"prefix":"10.1111","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8010-9449","authenticated-orcid":false,"given":"Che Matthew","family":"Harris","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan S.","family":"Abougergi","sequence":"additional","affiliation":[{"name":"Department on Internal Medicine, Division of Gastroenterology University of South Carolina School of Medicine  Columbia South Carolina USA"},{"name":"Catalyst Medical Consulting  Simpsonville South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott Mitchell","family":"Wright","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199611)13:11<967::AID-DIA266>3.0.CO;2-K"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2.491"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2017.1305891"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0134914"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0491-1"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2189"},{"key":"e_1_2_9_9_1","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases. Overweight and Obesity Statistics. URL:https:\/\/www.niddk.nih.gov\/health-information\/health-statistics\/overweight-obesity(Accessed 13 September 2017)."},{"key":"e_1_2_9_10_1","unstructured":"Centers for Disease Control and Prevention. Diabetes Public Health Resource: Diagnosed Diabetes. URL:https:\/\/www.cdc.gov\/diabetes\/home\/index.html(Accessed 5 January 2018)."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600506"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0585"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310799"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2016-000200"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004189"},{"key":"e_1_2_9_16_1","unstructured":"National Inpatient Sample. 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