Association of history of heart failure with hospital outcomes of hyperglycemic crises: Analysis from a University hospital and national cohort

Manyoo A. Agarwal, Nidhi Jain, Pradeep S.B. Podila, Vinithra Varadarajan, Brijesh Patel, Mahek Shah, Lohit Garg, Rami N. Khouzam, Uzoma Ibebuogu, Guy L. Reed, Samuel Dagogo-Jack

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Aims: The impact of a history of heart failure (HF) on the outcomes of hospitalization for hyperglycemic crises (diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome) is unknown. We aimed to test the hypothesis that a history of HF has a deleterious impact on the outcomes of hospitalization for hyperglycemic crises. Methods: We used two different datasets: National Inpatient Sample database 2003–2014 and a single University hospital cohort 2007–2017, to identify all adult hospitalizations with a primary diagnosis of hyperglycemic crises. Multivariable regression models were used to analyze the outcomes of in-hospital mortality, length of hospital stay and transfer to nursing home or similar short-term facility between HF and no-HF hospitalizations. Results: Of the 1, 570,726 hyperglycemic crises related hospitalizations, a history of HF was present in 57, 520 (3.6%) hospitalizations. After multivariable risk-adjustment, HF group had a higher observed in-hospital mortality [0.4% vs. 0.2%; adjusted odds ratio (AOR) = 1.7, 95% CI 1.4 to 2.0, P <.001] and transfer to nursing home or similar short-term facility (3.9 vs. 2.8%, AOR = 1.4, 95% CI 1.3 to 1.5, P <.001) compared with no-HF group. Mean length of hospital stay [6.5 vs. 3.5 days; P <.001] was also higher for HF group than no-HF group. Data from the smaller University hospital cohort showed similar findings. Conclusions: Patients with a history of HF may be an under-recognized high-risk group among patients hospitalized for hyperglycemic crisis. Additional studies are warranted to clarify risk elements and optimize the inpatient care of individuals with hyperglycemic crises.

Original languageEnglish (US)
Article number107466
JournalJournal of Diabetes and its Complications
Volume34
Issue number1
DOIs
StatePublished - Jan 2020

Keywords

  • Diabetes
  • HCUP
  • Heart failure
  • Mortality
  • NIS
  • Nursing home
  • Outcomes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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