Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis
Background The increasing prevalence of diabetic ketoacidosis (DKA) related admissions poses a significant burden on the healthcare systems globally. However, data regarding the predictors of healthcare resource utilization in DKA is limited and inconsistent. This study aimed to identify key predict...
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Taylor & Francis Group
2023-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2023.2175031 |
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| author | Fateen Ata Adeel Ahmad Khan Ibrahim Khamees Phool Iqbal Zohaib Yousaf Bayan Z. M. Mohammed Reham Aboshdid Sandy K. K. Marzouk Haidar Barjas Madeha Khalid Ihab El Madhoun Mohammed Bashir Anand Kartha |
| author_facet | Fateen Ata Adeel Ahmad Khan Ibrahim Khamees Phool Iqbal Zohaib Yousaf Bayan Z. M. Mohammed Reham Aboshdid Sandy K. K. Marzouk Haidar Barjas Madeha Khalid Ihab El Madhoun Mohammed Bashir Anand Kartha |
| author_sort | Fateen Ata |
| collection | DOAJ |
| description | Background The increasing prevalence of diabetic ketoacidosis (DKA) related admissions poses a significant burden on the healthcare systems globally. However, data regarding the predictors of healthcare resource utilization in DKA is limited and inconsistent. This study aimed to identify key predictors of hospital length of stay (LOS), readmission and recurrent DKA episodes.Methods We undertook a retrospective cross-sectional analysis of all DKA admissions from 2015 to 2021 across four hospitals in Qatar. The primary outcomes were the length of stay (LOS), 90-day readmission and 6-month and 1-year DKA recurrence.Results We included 922 patients with a median age of 35 years (25–45). 62% were males with type-1 diabetes-mellitus (T1DM) and type-2 DM (T2DM), present in 52% and 48% of patients. The median LOS was 2.6 days (IQR 1.1–4.8), and the median DKA resolution time was 18 h (10.5–29). Male-gender, new-onset DM, higher Charlson Comorbidity Index (CCI), lower haemoglobin, sodium and potassium, higher urea, longer DKA duration and MICU admission predicted a longer LOS in a multivariate regression analysis. None of the factors were significantly associated with 90-day readmission. Patients with pre-existing T1DM were more likely to have a six-month DKA recurrence than pre-existing T2DM. Patients with a 6-month DKA recurrence, female gender and T1DM had higher odds of 12-month recurrence, whereas a consult with a diabetes educator at the index admission was associated with decreased odds of recurrence.Conclusions/interpretation This is the most extensive study from the Middle-East region reporting on LOS, readmissions and the recurrence of DKA. Results from this study with a diverse population may be valuable for physicians and healthcare systems to decrease the diabetes-related healthcare burden in DKA patients. |
| format | Article |
| id | doaj-art-d4a423b9835843a5ad4f862a8a484686 |
| institution | OA Journals |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-d4a423b9835843a5ad4f862a8a4846862025-08-20T01:55:18ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602023-12-0155153354210.1080/07853890.2023.2175031Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosisFateen Ata0Adeel Ahmad Khan1Ibrahim Khamees2Phool Iqbal3Zohaib Yousaf4Bayan Z. M. Mohammed5Reham Aboshdid6Sandy K. K. Marzouk7Haidar Barjas8Madeha Khalid9Ihab El Madhoun10Mohammed Bashir11Anand Kartha12Department of Endocrinology, Hamad Medical Corporation, Doha, QatarDepartment of Endocrinology, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, New York Medical College/Metropolitan Hospital Center, New York, NY, USADepartment of Medicine, Reading Hospital-Tower Health, West Reading, PA, USADepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Geriatrics, Hamad Medical Corporation, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Nephrology, Hamad Medical Corporation, Doha, QatarDepartment of Endocrinology, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarBackground The increasing prevalence of diabetic ketoacidosis (DKA) related admissions poses a significant burden on the healthcare systems globally. However, data regarding the predictors of healthcare resource utilization in DKA is limited and inconsistent. This study aimed to identify key predictors of hospital length of stay (LOS), readmission and recurrent DKA episodes.Methods We undertook a retrospective cross-sectional analysis of all DKA admissions from 2015 to 2021 across four hospitals in Qatar. The primary outcomes were the length of stay (LOS), 90-day readmission and 6-month and 1-year DKA recurrence.Results We included 922 patients with a median age of 35 years (25–45). 62% were males with type-1 diabetes-mellitus (T1DM) and type-2 DM (T2DM), present in 52% and 48% of patients. The median LOS was 2.6 days (IQR 1.1–4.8), and the median DKA resolution time was 18 h (10.5–29). Male-gender, new-onset DM, higher Charlson Comorbidity Index (CCI), lower haemoglobin, sodium and potassium, higher urea, longer DKA duration and MICU admission predicted a longer LOS in a multivariate regression analysis. None of the factors were significantly associated with 90-day readmission. Patients with pre-existing T1DM were more likely to have a six-month DKA recurrence than pre-existing T2DM. Patients with a 6-month DKA recurrence, female gender and T1DM had higher odds of 12-month recurrence, whereas a consult with a diabetes educator at the index admission was associated with decreased odds of recurrence.Conclusions/interpretation This is the most extensive study from the Middle-East region reporting on LOS, readmissions and the recurrence of DKA. Results from this study with a diverse population may be valuable for physicians and healthcare systems to decrease the diabetes-related healthcare burden in DKA patients.https://www.tandfonline.com/doi/10.1080/07853890.2023.2175031Diabetic ketoacidosisDKAtype 1 diabetestype 2 diabeteslength of stayrecurrence |
| spellingShingle | Fateen Ata Adeel Ahmad Khan Ibrahim Khamees Phool Iqbal Zohaib Yousaf Bayan Z. M. Mohammed Reham Aboshdid Sandy K. K. Marzouk Haidar Barjas Madeha Khalid Ihab El Madhoun Mohammed Bashir Anand Kartha Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis Annals of Medicine Diabetic ketoacidosis DKA type 1 diabetes type 2 diabetes length of stay recurrence |
| title | Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis |
| title_full | Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis |
| title_fullStr | Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis |
| title_full_unstemmed | Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis |
| title_short | Clinical and biochemical determinants of length of stay, readmission and recurrence in patients admitted with diabetic ketoacidosis |
| title_sort | clinical and biochemical determinants of length of stay readmission and recurrence in patients admitted with diabetic ketoacidosis |
| topic | Diabetic ketoacidosis DKA type 1 diabetes type 2 diabetes length of stay recurrence |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2023.2175031 |
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