ABSTRACT Objective To determine the incidence and risk factors associated with postoperative stump complications in diabetic patients who underwent amputation using a nationwide cohort study. Method A retrospective cohort analysis was conducted using the Nationwide Inpatient Sample (NIS) database from 2010 to 2019. Patients were categorized into two groups based on the presence or absence of stump complications. Patient demographics (age, sex, and race), hospital characteristics (admission type, payer status, bed size, teaching status, location, and region), length of stay (LOS), total hospitalization charges, in‐hospital mortality, comorbidities, and perioperative complications were analyzed. Risk factors were identified using multivariate logistic regression analysis, incorporating patient demographics, hospitalization parameters, economic indicators, and comorbidities. Results A total of 101, 015 patients were included, of whom 6547 developed stump complications, yielding an overall incidence of 6. 5%. Patients with stump complications had longer hospital stays (7 vs. 5 days, p < 0. 0001) and higher total hospitalization charges (52, 248 vs. 40, 226, p < 0. 0001) than those without complications. Multivariable analysis showed that Black race, Hispanic ethnicity, Native American heritage, larger hospital bed size, greater comorbidity burden, weight loss, peripheral vascular disease, blood transfusion, hemorrhage/hematoma, wound dehiscence/non‐healing, and wound infection were independently associated with higher odds of stump complications. Conclusion Several demographic, hospital‐level, and clinical factors were associated with postoperative stump complications in diabetic patients undergoing amputation. These findings may help improve perioperative risk stratification and identify patients who warrant closer postoperative monitoring.
Wang et al. (Mon,) studied this question.