Frequency of Hypoglycemia and its Impact on Length of Stay,Mortality, and Short-Term Readmission in Patients with Diabetes Hospitalized In Internal Medicine Wards |
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| Institution: | 1. Servicio de Medicina Interna, Hospital Universitario Fuenlabrada, Madrid, Spain;2. Servicio de Medicina Interna Hospital Regional Universitario Carlos Haya, Málaga, Spain;3. Servicio de Endocrinología, Hospital Universitario Fuenlabrada, Madrid, Spain;4. Servicio de Medicina Interna, Hospital Rey Juan Carlos, Móstoles;5. Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, Spain;6. Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, Spain.;1. Department of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;2. Department of Pathology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan;3. Department of Nephro-urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.;1. Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine;2. Department of Endocrinology, Metabolism, and Infectious Diseases, Hirosaki University School of Medicine & Hospital;3. Clinical Research Institute, National Hospital Organization, Kyoto Medical Center;4. Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine;1. Division of Community Internal Medicine, Scottsdale, Arizona;2. Divisions of Endocrinology and Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Scottsdale, Arizona;3. The Epsilon Group, Charlottesville, Virginia.;4. Alere Informatics Solutions, Charlottesville, Virginia. |
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| Abstract: | ObjectiveTo evaluate whether hypoglycemia is associated with increases in length of stay (LOS), inpatient mortality, and readmission among patients with diabetes hospitalized in internal medicine wards.MethodsA retrospective cohort study was carried out using the Basic Minimum Data Set registry of the Spanish National Health System, which contains clinical and administrative information for every patient discharged from system hospitals. The analysis included patients discharged between January 2005 and December 2010 and had a primary (i.e., reason for the admission) or secondary diagnosis of diabetes and a secondary diagnosis of hypoglycemia. The associations between hypoglycemia and the study outcomes (mortality, readmission, and LOS) were evaluated using multivariate and multilinear regression models that included age, sex, and the Charlson index as covariates.ResultsDuring the study period, 3,361,104 patients were admitted to internal medicine wards in the National Health System. Of these, 921,306 (27.4%) had diagnoses of diabetes, and among these patients, 46,408 (5%) had secondary hypoglycemia. A total of 4,754 (10.2%) patients with secondary hypoglycemia died during their hospital stays, compared with 83,508 (9.5%) patients without hypoglycemia. The multivariate/multilinear regression models demonstrated significant associations between the presence of secondary hypoglycemia and greater inpatient mortality (odds ratio OR] 1.24, 95% confidence interval CI] 1.20-1.28), a greater likelihood of readmission (OR 1.20, 95% CI 1.17-1.23), and an increased LOS (b 1.24, 95% CI 1.15-1.35).ConclusionHypoglycemia in patients with diabetes hospitalized in internal medicine wards is associated with increases in the LOS, inpatient mortality, and early readmission. (Endocr Pract. 2014;20:870-875) |
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