Effect of full correction versus partial correction of elevated blood glucose in the emergency department on hospital length of stay

There is limited information to guide the extent to which asymptomatic hyperglycemia needs to be corrected in patients presenting to the emergency department (ED) with unrelated complaints. The objective of this study was to compare full correction (FC) versus partial correction (PC) of elevated blood glucose in the ED on hospital length of stay. This was a retrospective cohort study conducted in an academic ED in the United States. Adult diabetic patients with hyperglycemia (blood glucose >200 mg/dL) in the ED who were treated with subcutaneous insulin were included. Patients were categorized based on the level of blood glucose control achieved within the first 24 hours from triage: (1) FC group for whom blood glucose <200 mg/dL was achieved or (2) PC group for whom blood glucose remained ≥200 mg/dL. The primary outcome measure was a comparison of hospital length of stay between groups. A total of 161 patients were included in this study (FC 81, PC 80). There was no significant difference between hospital length of stay in the FC [3 days (interquartile range, 1-5 days)] and PC [3 days (interquartile range, 2-6 days)] groups (P 0.159). In the multivariate analysis, after adjusting for potential confounders, there was no significant association between level of correction and hospital length of stay (log-transformed) (coefficient 0.238; 95% confidence interval, -0.062 to 0.537; P 0.119; R 2 13%). The extent of glucose correction was not associated with a decrease in hospital length of stay in diabetic patients with hyperglycemia in the ED.