Hyperglycemia is associated with increased length of stay and total cost in patients hospitalized for congestive heart failure

Santhi Adigopula, Yan Feng, Varsha Babu, Konstantinos M. Parperis, Yaw Amoateng-Adjepong, Stuart Zarich

Department of Internal Medicine, Bridgeport Hospital, Yale University School of Medicine, Bridgeport, USA.
Division of Cardiology, Department of Internal Medicine, Bridgeport Hospital, Yale University School of Medicine, Bridgeport, USA.

DOI: 10.4236/wjcd.2013.32038                

Abstract

Objectives: Hyperglycemia is a well-known marker of poor clinical outcomes in acute myocardial infarction and critical illness; however, its effect in congestive heart failure (CHF) is controversial. We hypothesized that persistent hyperglycemia is associated with increased length of stay (LOS) and increased total cost in patients admitted with CHF. Methods: We studied 203 consecutive patients admitted with a primary diagnosis of CHF. Patient characteristics, admission glucose, mean blood glucose (MBG) during the entire hospital stay, length of stay, total cost, and readmission rates were assessed. Persistent hyperglycemia was defined as a MBG level ≥140 mg/dl. Results:Patients with persistent hyperglycemia had longer mean LOS (8.1 vs 5.2 days, p = 0.001) and higher total hospital costs (median $8940 vs $6892, p = 0.01) independent of diabetes status. Similarly, prolonged hospital stay >7 days (38% vs 21%; p = 0.01) and total cost >$10,000/patient (46% vs 29%; p = 0.01) were seen more commonly in patients with poor glucometrics. Neither admission glucose >140 mg/ dL or diabetes status was predictive of total costs or LOS. In multivariate linear regression, only MBG ≥ 140 mg/dl was associated with increased LOS and total cost. Patients with persistent hyperglycemia also had higher 6 months all-cause readmission rates (51% vs 37%; p = 0.03). Conclusion: Persistent hyperglycemia (MBG > 140 mg/dL), but not admission glucose, was associated with increased LOS, total cost and readmission rates independent of diabetes status. Our study emphasizes the need to further examine the role of glycemic control in patients admitted with CHF.

Keywords

Congestive Heart Failure; Persistent Hyperglycemia; Length of Stay; Total Cost; Diabetes; Admission Glucose

Conflicts of Interest

The authors declare no conflicts of interest.

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