Effects of Comorbidities, Inflammation and Glycaemic Control on Length of Hospital Stay/Potentially Avoidable Readmission Risk in Type 2 Diabetic Patients- A Retrospective Analysis

Abstract

BACKGROUND Patients with diabetes can have long hospitalization and frequent readmissions for different reasons. Predicting the duration of hospitalization and readmission risk may be helpful for management. We wanted to identify factors that affect the length of hospital stay and potentially avoidable readmission risk. METHODS 102 type 2 adults with diabetes that were hospitalized and discharged between July 2017 and July 2018 in Kirikkale University, Department of Internal Medicine, were investigated retrospectively. HOSPITAL score was calculated for detecting 30-day readmission risk. Haemoglobin A1c for glycaemic control, C-reactive protein/serum albumin ratio (CAR) for inflammation, Charlson comorbidity score for multimorbidities, and age were researched as factors that affect the length of stay/ HOSPITAL score. RESULTS There were 70 female and 32 male patients. The median age of participants was 69. Median HbA1c was 9.2%, median Charlson comorbidity score was 6, median CAR was 3.33, median HOSPITAL score was 4. Significant positive correlation was detected between age, Charlson comorbidity score, CAR, HbA1c level and both hospital length of stay/HOSPITAL score by Spearman's correlation analysis. However, Charlson comorbidity score and CAR had significant values with both length of hospital stay/ HOSPITAL score according to the linear regression model. CONCLUSIONS Identifying the factors that affect readmission and length of stay, benefits hospitalized diabetes patient management. This can have favourable impact on costs, sources and approach. Type 2 diabetes patients can have multiple comorbidities and inflammatory conditions. Inflammation and comorbidity presence have negative effects on length of stay and avoidable readmission. Presence of these indices' in high levels should be considered high risk for readmission and these patients should be evaluated carefully.