{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:06:47Z","timestamp":1792300007305,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T00:00:00Z","timestamp":1484092800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Background\/Aims<\/jats:title><jats:p>Lower limb (<jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content>) cellulitis\u2010related hospitalisations are prevalent in type 2 diabetes subjects. We assess its costs and factors associated with length of stay and readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case\u2010control study at an urban hospital servicing a multi\u2010ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content> cellulitis in 2008\u20132013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions. Glycaemic control was assessed by <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> measured within 6 months of the index admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 4600 admissions with <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content> 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, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), independent of age, ethnicity and <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>. Accompanying <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content> ulceration was more frequent in type 2 diabetes patients (50% vs 17%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001); however, admissions remained longer for type 2 diabetes patients without ulceration (median 3.4 vs 2.8 days, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Readmission rates were also higher in type 2 diabetes patients compared to non\u2010diabetes patients (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.7, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), even in the absence of ulceration (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.2, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Age, <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A high proportion of patients with type 2 diabetes was admitted with <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content> cellulitis. They had significantly longer admissions and higher readmission rates. Age, <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> and ethnicity did not predict length of stay or recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13299","type":"journal-article","created":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T13:32:47Z","timestamp":1476711167000},"page":"82-88","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of type 2 diabetes with prolonged hospital stay and increased rate of readmission in patients with lower limb cellulitis"],"prefix":"10.1111","volume":"47","author":[{"given":"S. M.","family":"Wijayaratna","sequence":"first","affiliation":[{"name":"Auckland Diabetes Centre Greenlane Clinical Centre  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Cundy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. L.","family":"Drury","sequence":"additional","affiliation":[{"name":"Auckland Diabetes Centre Greenlane Clinical Centre  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Auckland Diabetes Centre Greenlane Clinical Centre  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. A.","family":"Wijayaratna","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Science University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Wu","sequence":"additional","affiliation":[{"name":"Auckland Diabetes Centre Greenlane Clinical Centre  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1509.081228"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.14.1585"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2.510"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/431587"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060057"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08503.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08423.x"},{"key":"e_1_2_7_9_1","unstructured":"Auckland District Healthboard. 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