Diabetes-Associated Complications Increase Hospital Readmission Rates

Diabetes-associated complications are linked with an increased risk for repeat hospitalizations, and severe dysglycemia was an independent risk factor for readmissions, according to the findings of a recent study.

In the retrospective analysis, the researchers analyzed data from the OptumLabs Data Warehouse, which included a cohort of 342,186 patients over 18 years of age who had diabetes and were discharged from a hospital between January 1, 2009 and December 21, 2014. The mean age was 68.2 years, 51.9% of patients were female, and 67.8% of patients were white. Associations between principal diagnoses and risk factors with unplanned hospital readmissions 30 days after discharge were assessed as the study’s primary outcome, and additional analyses compared severe dysglycemia with all other causes.
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Overall, 594,146 hospitalizations were indexed and the all-cause 30-day readmission rate was 10.8%.

The most common cause of hospitalization and readmission was heart failure, which accounted for 5.5% of indexed hospitalizations and 8.9% of readmissions.

In addition, severe dysglyecmia accounted for 2.6% of indexed hospitalizations, with 48.1% of patients hospitalized with hyperglycemia, 50.4% of patients hospitalized with hypoglycemic, and 1.5% were unspecified. Readmissions related to severe dysglyecmia accounts for 2.5%, with 38.3% of patients readmitted with hyperglycemia, 61% readmitted with hypoglycemia, and 0.7% were unspecified.

The presence of severe dysglycemia at index or prior hospitalization, the Diabetes Complications Severity Index, and younger age were the strongest risk factors predisposing patients to severe dysglycemia compared with other causes for readmission. Severe dysglycemia and the Diabetes Complications Severity Index were independent risk factors for other causes of readmission, regardless of the first cause of indexed hospitalization.  

“Adults with diabetes are hospitalized and readmitted for a wide range of health conditions, and hospitalizations for severe hypoglycemia and hyperglycemia remain common, with high rates of recurrence,” the researchers concluded. “Severe dysglycemia is most likely to occur among younger patients with multiple diabetes complications and prior history of such events.”

—Melissa Weiss

Reference:

McCoy RG, Lipska KJ, Herrin J, Jeffery MM, Krumholz HM, Shah ND. Hospital readmissions among commercially insured and Medicare Advantage beneficiaries with diabetes and the impact of severe hypoglycemic and hyperglycemic events [published online July 6, 2017]. J Gen Intern Med. doi:10.1007/s11606-017-4095-x.