Effects of early inpatient rehabilitation on hospital readmission among patients with lower limb amputation due to diabetes mellitus: a retrospective cohort study.

Abstract

This study examined the impact of inpatient rehabilitation in acute care hospitals on hospital readmission in patients undergoing lower limb amputation (LLA) due to diabetes mellitus (DM) using propensity score analysis. This retrospective cohort study utilized the JMDC database. Patients who underwent transtibial and transfemoral amputation with DM as the reason for admission or comorbidity were included. Patients were divided into the rehabilitation group (started rehabilitation within 14 days of admission) and the non-rehabilitation group (did not receive rehabilitation within 14 days of admission). The primary outcomes were hospital readmission within 30 and 60 days post-discharge. Overall, 594 patients were analyzed, with 481 receiving inpatient rehabilitation. After inverse probability weighting (IPW) adjustment, the rehabilitation group had a significantly longer hospital stay than the non-rehabilitation group (rehabilitation: 69.1 [53.4], non-rehabilitation: 39.9 [30.4] days, <i>p</i> < 0.01). Following IPW adjustment, rehabilitation was significantly associated with lower readmission within 30 (OR = 0.519, 95% CI = 0.368-0.734, <i>p</i> < 0.01) and 60 days (OR = 0.673, 95% CI = 0.495-0.913, <i>p</i> = 0.011). Early inpatient rehabilitation may be one way to reduce the risk of hospital readmission for patients with LLA due to DM.