Effects of hospital acquired conditions on length of stay for patients with diabetes.
Intern Med J. 2014 Jul 29;
Authors: Cromarty J, Parikh S, Lim WK, Acharya S, Jackson TJ
BACKGROUND: In-patients with diabetes have longer length of stays (LOS). Understanding patterns of in-hospital complications between patients with diabetes and others may reveal measures to improve patient welfare and minimise LOS.
OBJECTIVE: Evaluate the rates and types of hospital acquired conditions amongst patients with and without diabetes and assess any effects on LOS.
METHODS: 47615 admission episodes from The Northern Hospital over 12months were reviewed. Episodes were divided into four groups: 1) patients without diabetes, 2) patients with diabetes without end-organ sequelae (EOS), 3) patients with diabetes with EOS, and 4) a subset of non-diabetic patients with a Charlson Co-morbidity Score ≥1 (comparison group). The Classification of Hospital Acquired Diagnoses (CHADx) was applied to the groups to compare rates and types of in-patient complications. Linear regression was used to analyse the impact of the number of CHADx on LOS.
RESULTS: Almost 30% of admissions of patients with diabetes and EOS had at least one CHADx, compared with 13% for non-diabetes patients and 17% for the comparison group. The types of CHADx experienced by diabetes patients with EOS were similar to the comparison group. Rates, however, were 10 times higher. Linear regression demonstrated diabetes patients with EOS have increased LOS and each CHADx per episode has a larger effect on LOS.
CONCLUSION: We demonstrate that diabetes patients have consistently higher rates of CHADx and longer LOS than similar patients with complex and chronic conditions. This provides a foundation for future studies to investigate preventative practices for this high-risk patient population.
PMID: 25070621 [PubMed - as supplied by publisher]