J Cromarty1, S Parikh, W K Lim, S Acharya, T J Jackson. 1. The Northern Hospital, Melbourne, Victoria, Australia; Northern Clinical Research Centre, Northern Health, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Inpatients 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. AIM: This study evaluates the rates and types of hospital-acquired conditions among patients with and without diabetes and assesses any effects on LOS. METHODS: A total of 47 615 admission episodes from The Northern Hospital over 12 months was reviewed. Episodes were divided into four groups: (i) patients without diabetes; (ii) patients with diabetes without end-organ sequelae (EOS); (iii) patients with diabetes with EOS; and (iv) 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 inpatient 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. However, rates 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.
BACKGROUND: Inpatients 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. AIM: This study evaluates the rates and types of hospital-acquired conditions among patients with and without diabetes and assesses any effects on LOS. METHODS: A total of 47 615 admission episodes from The Northern Hospital over 12 months was reviewed. Episodes were divided into four groups: (i) patients without diabetes; (ii) patients with diabetes without end-organ sequelae (EOS); (iii) patients with diabetes with EOS; and (iv) a subset of non-diabeticpatients 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 inpatient 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-diabetespatients and 17% for the comparison group. The types of CHADx experienced by diabetespatients with EOS were similar to the comparison group. However, rates were 10 times higher. Linear regression demonstrated diabetespatients with EOS have increased LOS and each CHADx per episode has a larger effect on LOS. CONCLUSION: We demonstrate that diabetespatients 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.