The Association of Glucose Values at Hospital Discharge with 30-Day Readmission and Post-discharge Mortality Rates in Patients with Diabetes

Abstract

Objective: Thirty-day readmission and post-discharge mortality rates reflect quality of care. Little is known about the association of glucose values of the last day of the inpatient stay with the risk of readmission and mortality after discharge. Design: Nationwide cohort of 836,189 admissions of DM patients admitted to non ICU setting in 110 Veteran Affairs hospitals, between 2000-2014. Demographic, social economic variables and several comorbidities were collected. General estimating equations were used to determine if the minimum glucose values of the last 24 hours of hospital stay were associated with 30-day readmission rate, 30, 90 and 180-day mortality rates, and combined 30-day readmission/mortality. Results: The 30-day readmission rate was 17.2% and the 30, 90 and 180-day mortality rates were 2.3%, 6.1% and 10% respectively, with a combined 18.8% for 30-day mortality/readmission rates. There was a sharp increase of the 30-day readmission rate with glucose values below 98 mg/dl. The post-discharge mortality rates increased with glucose values below 68.3 mg/dl, and the combined 30-day readmission/mortality rate increased with glucose values below 86.4 mg/dl (Figure). Conclusions: DM patients with glucose values below 98 mg/dl and 68.3 mg/dl at the last day of hospitalization in the non ICU setting are at a higher risk for 30-day readmission and 180-day mortality. Disclosure E. Spanakis: Research Support; Self; Dexcom, Inc. G.E. Umpierrez: Research Support; Self; Sanofi US, Merck & Co., Inc., Novo Nordisk Inc., AstraZeneca. Advisory Panel; Self; Sanofi, Intarcia Therapeutics, Inc.. T. Siddiqui: None. M. Zhan: None. S. Snitker: Employee; Self; Novo Nordisk Inc.. J.C. Fink: None. J.D. Sorkin: None.