TITLE:
Hyperglycemia is associated with increased length of stay and total cost in patients hospitalized for congestive heart failure
AUTHORS:
Santhi Adigopula, Yan Feng, Varsha Babu, Konstantinos M. Parperis, Yaw Amoateng-Adjepong, Stuart Zarich
KEYWORDS:
Congestive Heart Failure; Persistent Hyperglycemia; Length of Stay; Total Cost; Diabetes; Admission Glucose
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.2,
April
30,
2013
ABSTRACT:
Objectives: Hyperglycemia is a well-known marker of poor
clinical outcomes in acute myocardial infarction and critical illness; however,
its effect in congestive heart failure (CHF) is controversial. We hypothesized that
persistent hyperglycemia is associated with increased length of stay (LOS) and
increased total cost in patients admitted with CHF. Methods: We studied 203 consecutive
patients admitted with a primary diagnosis of CHF. Patient characteristics, admission
glucose, mean blood glucose (MBG) during
the entire hospital stay, length of stay, total cost, and readmission rates were
assessed. Persistent hyperglycemia was defined as a MBG level ≥140 mg/dl. Results:Patients with
persistent hyperglycemia had longer mean LOS (8.1 vs 5.2 days, p = 0.001) and higher
total hospital costs (median $8940 vs $6892, p = 0.01) independent of diabetes
status. Similarly, prolonged hospital stay >7 days (38% vs 21%; p = 0.01) and
total cost >$10,000/patient (46% vs 29%; p = 0.01) were seen more commonly in
patients with poor glucometrics. Neither admission glucose >140 mg/ dL or diabetes status was predictive of total costs or LOS. In multivariate linear regression,
only MBG ≥ 140 mg/dl was associated with increased LOS and total cost. Patients with persistent hyperglycemia also had higher
6 months all-cause readmission rates (51% vs 37%; p = 0.03). Conclusion: Persistent
hyperglycemia (MBG > 140 mg/dL), but not admission glucose, was associated
with increased LOS, total cost and readmission rates independent of diabetes status.
Our study emphasizes the need to further examine the role of glycemic control
in patients admitted with CHF.