Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions

ObjectiveHypoglycemia is a serious complication of diabetes treatment. This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Researc...

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Published in:BMJ open diabetes research & care 2016, Vol.4 (1), p.e000160-e000160
Main Authors: Emons, M F, Bae, J P, Hoogwerf, B J, Kindermann, S L, Taylor, R J, Nathanson, B H
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Language:English
Subjects:
African Americans
Age
Bias
Coma
Data bases
Dementia
Diabetes
Emergency medical care
Emotional disorders
Epidemiology/Health Services Research
Health care access
Health care policy
Health Insurance Portability & Accountability Act 1996-US
Hospitals
Hypoglycemia
Laboratories
Mortality
Race
Socioeconomic factors
Studies
Variables
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container_title BMJ open diabetes research & care
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creator Emons, M F
Bae, J P
Hoogwerf, B J
Kindermann, S L
Taylor, R J
Nathanson, B H
description ObjectiveHypoglycemia is a serious complication of diabetes treatment. This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Research design and methods4476 hypoglycemia-related ER and in-pt encounters with discharge dates from 1/1/2009 to 3/31/2014 were identified in a large, multicenter electronic health record database. Outcomes were 30-day all-cause ER/hospital readmission and hypoglycemia-related readmission. Multivariable logistic regression methods identified risk factors for both outcomes.Results1095 (24.5%) encounters had ER/hospital all-cause readmission within 30 days and 158 (14.4%) of these were hypoglycemia-related. Predictors of all-cause 30-day readmission included recent exposure to a hospital/nursing home (NH)/skilled nursing facility (SNF; OR 1.985, p
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This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Research design and methods4476 hypoglycemia-related ER and in-pt encounters with discharge dates from 1/1/2009 to 3/31/2014 were identified in a large, multicenter electronic health record database. Outcomes were 30-day all-cause ER/hospital readmission and hypoglycemia-related readmission. Multivariable logistic regression methods identified risk factors for both outcomes.Results1095 (24.5%) encounters had ER/hospital all-cause readmission within 30 days and 158 (14.4%) of these were hypoglycemia-related. Predictors of all-cause 30-day readmission included recent exposure to a hospital/nursing home (NH)/skilled nursing facility (SNF; OR 1.985, p&lt;0.001); age 25–34 and 35–44 (OR 2.334 and 1.996, respectively, compared with age 65–74, both p&lt;0.001); and African-American (AA) race versus all other race categories (OR 1.427, p=0.011). Other factors positively associated with readmission include chronic obstructive pulmonary disease, cerebrovascular disease, cardiac dysrhythmias, congestive heart disease, hypertension, and mood disorders. Predictors of readmissions attributable to hypoglycemia included recent exposure to a hospital/NH/SNF (OR 2.299, p&lt;0.001), AA race (OR 1.722, p=0.002), age 35–44 (OR 3.484, compared with age 65–74, p&lt;0.001), hypertension (OR 1.891, p=0.019), and delirium/dementia and other cognitive disorders (OR 1.794, p=0.038). Obesity was protective against 30-day hypoglycemia-related readmission (OR 0.505, p=0.017).ConclusionsFactors associated with 30-day all-cause and hypoglycemia-related readmission among patients with diabetic hypoglycemia include recent exposure to hospital/SNF/NH, adults &lt;45 years, AAs, and several cardiovascular and respiratory-related comorbid conditions.</description><identifier>ISSN: 2052-4897</identifier><identifier>EISSN: 2052-4897</identifier><identifier>DOI: 10.1136/bmjdrc-2015-000160</identifier><identifier>PMID: 27110366</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>African Americans ; Age ; Bias ; Coma ; Data bases ; Dementia ; Diabetes ; Emergency medical care ; Emotional disorders ; Epidemiology/Health Services Research ; Health care access ; Health care policy ; Health Insurance Portability &amp; Accountability Act 1996-US ; Hospitals ; Hypoglycemia ; Laboratories ; Mortality ; Race ; Socioeconomic factors ; Studies ; Variables</subject><ispartof>BMJ open diabetes research &amp; care, 2016, Vol.4 (1), p.e000160-e000160</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b468t-eef6ac529c5029d76da015c0b67ccf914ac7e4a81b8a7791e93c1b0e7d7820b93</citedby><cites>FETCH-LOGICAL-b468t-eef6ac529c5029d76da015c0b67ccf914ac7e4a81b8a7791e93c1b0e7d7820b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1783932305/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1783932305?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,4009,25732,27528,27529,27902,27903,27904,36991,36992,44569,53769,53771,74872,77347,77378</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27110366$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Emons, M F</creatorcontrib><creatorcontrib>Bae, J P</creatorcontrib><creatorcontrib>Hoogwerf, B J</creatorcontrib><creatorcontrib>Kindermann, S L</creatorcontrib><creatorcontrib>Taylor, R J</creatorcontrib><creatorcontrib>Nathanson, B H</creatorcontrib><title>Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions</title><title>BMJ open diabetes research &amp; care</title><addtitle>BMJ Open Diabetes Res Care</addtitle><description>ObjectiveHypoglycemia is a serious complication of diabetes treatment. This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Research design and methods4476 hypoglycemia-related ER and in-pt encounters with discharge dates from 1/1/2009 to 3/31/2014 were identified in a large, multicenter electronic health record database. Outcomes were 30-day all-cause ER/hospital readmission and hypoglycemia-related readmission. Multivariable logistic regression methods identified risk factors for both outcomes.Results1095 (24.5%) encounters had ER/hospital all-cause readmission within 30 days and 158 (14.4%) of these were hypoglycemia-related. Predictors of all-cause 30-day readmission included recent exposure to a hospital/nursing home (NH)/skilled nursing facility (SNF; OR 1.985, p&lt;0.001); age 25–34 and 35–44 (OR 2.334 and 1.996, respectively, compared with age 65–74, both p&lt;0.001); and African-American (AA) race versus all other race categories (OR 1.427, p=0.011). Other factors positively associated with readmission include chronic obstructive pulmonary disease, cerebrovascular disease, cardiac dysrhythmias, congestive heart disease, hypertension, and mood disorders. Predictors of readmissions attributable to hypoglycemia included recent exposure to a hospital/NH/SNF (OR 2.299, p&lt;0.001), AA race (OR 1.722, p=0.002), age 35–44 (OR 3.484, compared with age 65–74, p&lt;0.001), hypertension (OR 1.891, p=0.019), and delirium/dementia and other cognitive disorders (OR 1.794, p=0.038). Obesity was protective against 30-day hypoglycemia-related readmission (OR 0.505, p=0.017).ConclusionsFactors associated with 30-day all-cause and hypoglycemia-related readmission among patients with diabetic hypoglycemia include recent exposure to hospital/SNF/NH, adults &lt;45 years, AAs, and several cardiovascular and respiratory-related comorbid conditions.</description><subject>African Americans</subject><subject>Age</subject><subject>Bias</subject><subject>Coma</subject><subject>Data bases</subject><subject>Dementia</subject><subject>Diabetes</subject><subject>Emergency medical care</subject><subject>Emotional disorders</subject><subject>Epidemiology/Health Services Research</subject><subject>Health care access</subject><subject>Health care policy</subject><subject>Health Insurance Portability &amp; Accountability Act 1996-US</subject><subject>Hospitals</subject><subject>Hypoglycemia</subject><subject>Laboratories</subject><subject>Mortality</subject><subject>Race</subject><subject>Socioeconomic factors</subject><subject>Studies</subject><subject>Variables</subject><issn>2052-4897</issn><issn>2052-4897</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>PIMPY</sourceid><recordid>eNqNkUuLFDEUhYMozjDOH3AhATduonlU5bERZNAZYUAQXYdUcqsnbVXSJtUj_e9NU2MzunJ1w813DvdwEHrJ6FvGhHw3zNtQPOGU9YRSyiR9gs457TnptFFPH73P0GWt2yMjJBO6f47OuGKMCinP0fZrrD_w6PySS8VjLlhQEtwBF3BhjrXGnNp6mvKvmDb47rDLm-ngYY6OFJjcAgHDDGUDyTdRzjN2KeCYdm6JkBZ8cqkv0LPRTRUuH-YF-v7p47erG3L75frz1YdbMnRSLwRglM733PiechOUDK5l9HSQyvvRsM55BZ3TbNBOKcPACM8GCioozelgxAV6v_ru9sMMwbcripvsrsTZlYPNLtq_f1K8s5t8bzsttJSiGbx5MCj55x7qYlsED9PkEuR9tUzprpOCm66hr_9Bt3lfUot3pIQRXNC-UXylfMm1FhhPxzBqj23atU17bNOubTbRq8cxTpI_3TWArEAT_4_hb1gqrME</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Emons, M F</creator><creator>Bae, J P</creator><creator>Hoogwerf, B J</creator><creator>Kindermann, S L</creator><creator>Taylor, R J</creator><creator>Nathanson, B H</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2016</creationdate><title>Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions</title><author>Emons, M F ; Bae, J P ; Hoogwerf, B J ; Kindermann, S L ; Taylor, R J ; Nathanson, B H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b468t-eef6ac529c5029d76da015c0b67ccf914ac7e4a81b8a7791e93c1b0e7d7820b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>African Americans</topic><topic>Age</topic><topic>Bias</topic><topic>Coma</topic><topic>Data bases</topic><topic>Dementia</topic><topic>Diabetes</topic><topic>Emergency medical care</topic><topic>Emotional disorders</topic><topic>Epidemiology/Health Services Research</topic><topic>Health care access</topic><topic>Health care policy</topic><topic>Health Insurance Portability &amp; Accountability Act 1996-US</topic><topic>Hospitals</topic><topic>Hypoglycemia</topic><topic>Laboratories</topic><topic>Mortality</topic><topic>Race</topic><topic>Socioeconomic factors</topic><topic>Studies</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Emons, M F</creatorcontrib><creatorcontrib>Bae, J P</creatorcontrib><creatorcontrib>Hoogwerf, B J</creatorcontrib><creatorcontrib>Kindermann, S L</creatorcontrib><creatorcontrib>Taylor, R J</creatorcontrib><creatorcontrib>Nathanson, B H</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Databases</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open diabetes research &amp; care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Emons, M F</au><au>Bae, J P</au><au>Hoogwerf, B J</au><au>Kindermann, S L</au><au>Taylor, R J</au><au>Nathanson, B H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions</atitle><jtitle>BMJ open diabetes research &amp; care</jtitle><addtitle>BMJ Open Diabetes Res Care</addtitle><date>2016</date><risdate>2016</risdate><volume>4</volume><issue>1</issue><spage>e000160</spage><epage>e000160</epage><pages>e000160-e000160</pages><issn>2052-4897</issn><eissn>2052-4897</eissn><abstract>ObjectiveHypoglycemia is a serious complication of diabetes treatment. This retrospective observational study characterized hypoglycemia-related hospital emergency room (ER) and inpatient (in-pt) admissions and identified risk factors for 30-day all-cause and hypoglycemia-related readmission.Research design and methods4476 hypoglycemia-related ER and in-pt encounters with discharge dates from 1/1/2009 to 3/31/2014 were identified in a large, multicenter electronic health record database. Outcomes were 30-day all-cause ER/hospital readmission and hypoglycemia-related readmission. Multivariable logistic regression methods identified risk factors for both outcomes.Results1095 (24.5%) encounters had ER/hospital all-cause readmission within 30 days and 158 (14.4%) of these were hypoglycemia-related. Predictors of all-cause 30-day readmission included recent exposure to a hospital/nursing home (NH)/skilled nursing facility (SNF; OR 1.985, p&lt;0.001); age 25–34 and 35–44 (OR 2.334 and 1.996, respectively, compared with age 65–74, both p&lt;0.001); and African-American (AA) race versus all other race categories (OR 1.427, p=0.011). Other factors positively associated with readmission include chronic obstructive pulmonary disease, cerebrovascular disease, cardiac dysrhythmias, congestive heart disease, hypertension, and mood disorders. Predictors of readmissions attributable to hypoglycemia included recent exposure to a hospital/NH/SNF (OR 2.299, p&lt;0.001), AA race (OR 1.722, p=0.002), age 35–44 (OR 3.484, compared with age 65–74, p&lt;0.001), hypertension (OR 1.891, p=0.019), and delirium/dementia and other cognitive disorders (OR 1.794, p=0.038). Obesity was protective against 30-day hypoglycemia-related readmission (OR 0.505, p=0.017).ConclusionsFactors associated with 30-day all-cause and hypoglycemia-related readmission among patients with diabetic hypoglycemia include recent exposure to hospital/SNF/NH, adults &lt;45 years, AAs, and several cardiovascular and respiratory-related comorbid conditions.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27110366</pmid><doi>10.1136/bmjdrc-2015-000160</doi><oa>free_for_read</oa></addata></record>
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subjects African Americans
Age
Bias
Coma
Data bases
Dementia
Diabetes
Emergency medical care
Emotional disorders
Epidemiology/Health Services Research
Health care access
Health care policy
Health Insurance Portability & Accountability Act 1996-US
Hospitals
Hypoglycemia
Laboratories
Mortality
Race
Socioeconomic factors
Studies
Variables
title Risk factors for 30-day readmission following hypoglycemia-related emergency room and inpatient admissions
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