Thirty-Day Readmission After Hospitalisation for Diabetic Foot Ulcer: A Nationwide Analysis

Diabetic foot ulcers are a frequent cause of hospitalisation among adults with diabetes mellitus and are associated with substantial morbidity and mortality. Hospital readmissions following diabetic foot ulcer hospitalisation remain common, yet nationally representative evidence describing readmission patterns and drivers is limited. This retrospective cohort study used the 2022 Nationwide Readmissions Database to characterise 30-day all-cause readmission rates, identify factors associated with readmission and compare index and readmission hospitalisations among adults hospitalised with diabetic foot ulcers in the United States. Adult hospitalisations with a diagnosis of diabetic foot ulcer were identified using diagnosis codes, and survey-weighted analyses were performed to generate national estimates. Among an estimated 234,797 index hospitalisations, 13.3% of patients were readmitted within 30 days, exceeding the national inpatient average of 8.2%. Readmitted patients demonstrated a higher prevalence of kidney disease, cardiovascular disease and mental health conditions. In multivariable analyses, kidney disease, cardiovascular comorbidities, tobacco use, drug use disorder and bipolar disorder were associated with increased odds of readmission. In contrast, infection-related diagnoses and procedures during the index hospitalisation, including bone infection, surgical debridement and lower-extremity amputation, were associated with lower odds of readmission. Readmission encounters were characterised by longer hospital stays and higher prevalence of acute systemic conditions. These findings indicate that early readmission after hospitalisation for diabetic foot ulcer is driven primarily by systemic medical instability rather than recurrent local infection, underscoring the need for multidisciplinary inpatient and postdischarge care strategies.