Smoking is associated with a higher risk of unplanned medical visits among adult patients with diabetes, using retrospective electronic medical record data from 2014 to 2016

Abstract

Background: Smoking exacerbates the complications of diabetes, but little is known about whether patients with diabetes who smoke have more unplanned medical visits than those who do not smoke. This study examines the association between smoking status and unplanned medical visits among patients with diabetes. Methods: Data were drawn from electronic medical records (EMR's) from a large healthcare provider in the Northern Plains region of the US, from adult (≥18 years old) patients with type 1 or type 2 diabetes who received care at least once during 2014-16 (N = 62,149). The association between smoking status (current, former, or never smoker) and having ≥1 unplanned visit (comprised of emergency department visits, hospitalizations, hospital observations, and urgent care) was examined after adjusting for age, race/ethnicity, and body mass index (BMI). The top ten most common diagnoses for unplanned visits were examined by smoking status. Results: Both current and former smoking were associated with an approximately 1.2-fold increase in the odds of having at least one unplanned medical visit in the 3-year period (OR = 1.22, 95% CI = 1.16-129; OR = 1.23, 95% CI = 1.19-1.28, respectively), relative to never-smokers. Most common diagnoses for all patients were pain-related. However, diagnoses related to musculoskeletal system and connective tissue disorders were more common among smokers. Smoking is associated with a higher rate of unplanned medical visits among patients with diabetes in this regional healthcare system. Conclusions: Results from this study reveal higher rates of unplanned visits among smokers and former smokers, as well as increased frequencies of unplanned medical visits among current smokers.

Tobacco Smoking or Nicotine Phenotype and Severity of Clinical Presentation at the Emergency Department (SMOPHED): Protocol for a Noninterventional Observational Study

“…It is estimated that tobacco use accounts for 3%-6% of all ED visits and 5%-16% of total hospital expenses [ 28 - 30 ]. Smokers with preexisting diseases such as diabetes and asthma are more prone to ED visits than nonsmokers with similar conditions [ 23 , 31 ].…”

Hospital length of stay and readmission after elective surgery: a comparison of current and former smokers with non-smokers

“…Following surgery, smokers demonstrate poor wound healing, and have an elevated incidence of post-operative infections including surgical-site and respiratory infections [7]. Research has also shown that smokers with chronic diseases have higher rates of hospital readmissions than non-smokers [8,9].…”

Relationship between tobacco and nicotine products use and clinical presentation at the Emergency Department: study protocol

“…This is expected considering the disease burden caused by smoking, which might result in more ED visits for smokers compared to non-smokers. Current smoking as well as smoking relapse were found to be signi cantly associated with ED visits [20][21][22][23][24]. Accessing at ED often re ects the rst or the only contact of patients with the healthcare system, thus, the ED visit represents an opportunity to record smoking and nicotine use patterns.…”