Introduction: It has been shown that hypoglycemia and hyperglycemia in hospitalized patients are associated with adverse patient outcomes including increased length of stay and higher readmission rates. With 25-30% of hospitalized patients having a diagnosis of diabetes, this is an important population to optimize glycemic control in.
Data: Data was drawn from the Electronic Medical Records (EMR) at a large academic medical center in the northeastern United States. The sample was all hospitalizations from 2013-2018 for persons identified as diabetic in the EMR. The sample was limited to admission to general medicine services with a stay of 48 hours or more and excluded those in the intensive care unit; for a total sample size was 6,732.
Methods: We measured the effect of inpatient endocrinology consultations (IEC) within the first 48 hours on total length of stay (LOS) in days, complications, and 30-day all cause readmissions. We controlled for patient characteristics (age, gender, severity of illness, risk of mortality, BMI) in our multivariate analysis. Results: IEC led to a statistically significant (p<.001) reduction in mean LOS, with a consultation leading to a 1.17-day shorter average LOS. IEC had no statistically significant effect on the rate of inpatient complications (p=0.60), but did reduce the probability of a readmission by 0.60 percentage points (p=0.20).
Conclusion: This study showed that for patients with diabetes being admitted to medicine services, obtaining an IEC within 48 hours of admission significantly reduced mean LOS by 1.17 days. This is an important finding that could not only improve diabetes care and outcomes, but also lessen the economic burden.
K. Sheahan: None. A. Atherly: None. C.E. Dayman: None. J.J. Schnure: None.