Timing of HbA1c pre-admission: impact on readmission and in-hospital mortality in patients with diabetes

Arora, A; Shanmugasundaram, M; Varughese, GI; Duffs, C; Fryer, AA; Nayak, AU

Abstract

Aims: Association between high HbA1c and risk of all-cause hospital admissions is recognised. We aimed to investigate the impact of HbA1c screening pre-admission the time of admission, on readmission rates and in-hospital mortality.
Methods: Amongst all emergency admissions at the hospital over a 12 month period, those with diabetes with available HbA1c in the preceding 2 years were identified (n=3,161). Data on pre-admission HbA1c was obtained from in-house laboratory and data on in-hospital mortality, length of stay and readmission obtained from electronic patient records. The cohort was categorised into group 1 (HbA1c within 3 months prior to admission, n=1,438),group 2 (3–6 months prior to admission, n=803), group 3 (6–12 months prior to admission, n=708) and group 4 (>12 months prior to admission, n=212).
Results: Demographics: males 1,644 (52%); Caucasians 2,965(93.8%); age 70.215.1 years. 1,166 (36.9%) patients had≥2admissions. Inpatient mortality 10.9% (n=344). The proportion readmitted was higher in group 4 compared to groups 1, 2 and 3(48.6% vs 34.9%, 36.2% and 38.2% respectively, p=0.001). In-hospital mortality was lower (p=0.16, not significant) among patients in group 1 compared to groups 2, 3 and 4 (9.5% vs12.2%, 12.2% and 11.3% respectively).
Conclusions: An up to date pre-admission HbA1c testing(>12 months pre-admission in this study) appears to be associated with increased rate of readmission. This suggests that regular biochemical monitoring of diabetes is linked to patient outcomes. The impact of addressing glycaemic profile and other metabolic risk factors with regard to readmission is less commonly perceived in routine clinical practice.

Citation

Arora, A., Shanmugasundaram, M., Varughese, G., Duffs, C., Fryer, A., & Nayak, A. (2015, March). Timing of HbA1c pre-admission: impact on readmission and in-hospital mortality in patients with diabetes. Poster presented at Diabetes UK Professional Conference 2015, ExCel London, UK

• Presentation Conference Type: Poster
• Conference Name: Diabetes UK Professional Conference 2015
• Conference Location: ExCel London, UK
• Start Date: Mar 11, 2015
• End Date: Mar 13, 2015
• Deposit Date: Oct 5, 2023
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/dme.12668_1