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PREDICTORS FOR ADVERSE OUTCOMES IN DIABETIC KETOACIDOSIS IN A MULTIHOSPITAL HEALTH SYSTEM.
Endocr Pract. 2019 Oct 25;:
Authors: Xu AC, Broome DT, Bena JF, Lansang MC
Abstract
Objective: To determine predictors of prolonged length of stay (LOS), 30-day readmission, and 30-day mortality in a multihospital health system. Methods: We performed a retrospective review of 531 adults admitted with DKA to a multihospital health system between November 2015 and December 2016. Demographic and clinical data were collected. Linear regression was used to calculate Odds Ratios (OR) for predictors and their association with prolonged LOS (3.2 days), 30-day readmission, and 30-day mortality. Results: Significant predictors for prolonged LOS included: ICU admission (OR 2.12, CI 1.38-3.27), disease duration (non-linear) (OR1.28, CI 1.10-1.49), non-white race (OR 1.73, CI 1.15-2.60), age at admission (OR 1.03, CI 1.01-1.04), and Elixhauser Index (EI) (OR 1.21, CI 1.13-1.29). Shorter time to consult after admission [median (Q1, Q3) of 11.3 (3.9, 20.7) vs. 14.8 (7.4, 37.3) hours, p <0.001)] was associated with a shorter LOS. Significant 30-day readmission predictors included: Medicare insurance (OR 2.35, CI 1.13-4.86) and EI (OR 1.31, CI 1.21-1.41). Endocrine consultation was associated with reduced 30-day readmission (OR 0.51, CI 0.28-0.92 A predictive model for mortality was not generated because of low event rates. Conclusion: EI, non-white race, disease duration, age, Medicare, ICU admission are associated with adverse outcomes. Endocrinology consultation was associated with lower 30-day readmission, and earlier consultation resulted in a shorter LOS.
PMID: 31652103 [PubMed - as supplied by publisher]