Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

Abstract

The risk factors of rehospitalization and death post-discharge in diabetes-related hospital admissions are not fully understood. To determine them, a population-based retrospective epidemiological survey was performed on diabetes-related admissions from the Polish national database. Logistic regression models were used, in which the dependent variables were rehospitalization due to diabetes complications and death within 90 days after the index hospitalization. In 2017, there were 74,248 hospitalizations related to diabetes. A total of 11.3% ended with readmission. Risk factors for rehospitalization were as follows: age < 35 years; male sex; prior hospitalization due to acute diabetic complications; weight loss; peripheral artery disease; iron deficiency anemia; kidney failure; alcohol abuse; heart failure; urgent, emergency, or weekend admission; length of hospitalization; and hospitalization in a teaching hospital with an endocrinology/diabetology unit. Furthermore, 7.3% of hospitalizations resulted in death within 90 days following discharge. Risk factors for death were as follows: age; neoplastic disease with/without metastases; weight loss; coagulopathy; alcohol abuse; acute diabetes complications; heart failure; kidney failure; iron deficiency anemia; peripheral artery disease; fluid, electrolytes, and acid–base balance disturbances; urgent or emergency and weekend admission; and length of hospitalization. We concluded that of all investigated factors, only hospitalization within an experienced specialist center may reduce the frequency of the assessed outcomes.

Clinical Characteristics and Factors Associated with In-Hospital Mortality in 66 755 Patients Hospitalized Due to Diabetes in Poland, January to December 2019

“…A similar phenomenon was observed among those hospitalized due to type 2 diabetes: between 2010 and 2018, the in-hospital mortality rate increased from 1.9% to 2.76% among male patients and from 2.37% to 3.37% among female patients [ 24 ]. Moreover, Kozioł et al showed that of 74 248 diabetes-related hospitalizations in 2017, 7.3% resulted in death within 90 days following discharge [ 26 ]. Findings from this study showed differences in in-hospital mortality rates in type 1 (2.1%) and type 2 (3.3%) diabetes.…”

“…These data can be helpful for clinicians and policymakers to improve the management of diabetes in Poland. However, a limited amount of research on diabetes is based on national registries [ 22 – 26 ]. Most of the previously published data are focused on epidemiological analyses aimed at the prevalence of diabetes [ 22 , 25 ].…”

“…Goryński et al showed significant differences in the in-hospital mortality rate by sex, age, or year of admission [ 24 ]. Kozioł et al analyzed the predictors of rehospitalization and post-discharge death (up to 90 days) among the patients hospitalized due to all types of diabetes [ 26 ]. However, there is a lack of data on the impact of comorbidities on the risk of in-hospital death among patients hospitalized due to type 1 or type 2 diabetes.…”

Self-Care Practices and the Associated Socio-Demographic Variables of Persons With Type 2 Diabetes Mellitus (T2dm) in Southeast, Nigeria

“…As a chronic disease with chronic complications, diabetes sufferers are often faced with the challenge of short-term and long-term complications associated with frequent readmissions increasing length of hospital stays, and death. 9 One way to prevent frequent re-admission and early development of complications is to ensure that individuals with diabetes have adequate knowledge and ability for self-management. Self-management refers to a set of skilled behaviors engaged in managing one’s illness.…”