Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital

D Benaiges,1–3 JJ Chillarón,1–3 MJ Carrera,1,3 F Cots,3,4 J Puig de Dou,1 E Corominas,1 J Pedro-Botet,1–3 JA Flores-Le Roux,1–3 C Claret,1 A Goday,1–3 JF Cano1–3 1Department of Endocrinology and Nutrition, Hospital del Mar, 2Dep...

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Autores principales:	Benaiges D, Chillarón JJ, Carrera MJ, Cots F, Puig de Dou J, Corominas E, Pedro-Botet J, Flores-Le Roux JA, Claret C, Goday A, Cano JF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	day hospital conventional hospitalization hyperglycemic crisis Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/a120cfff67e44c6f95ff9139d3a8a060
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spelling	oai:doaj.org-article:a120cfff67e44c6f95ff9139d3a8a0602021-12-02T07:12:38ZEfficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital1178-1998https://doaj.org/article/a120cfff67e44c6f95ff9139d3a8a0602014-05-01T00:00:00Zhttps://www.dovepress.com/efficacy-of-treatment-for-hyperglycemic-crisis-in-elderly-diabetic-pat-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998D Benaiges,1–3 JJ Chillarón,1–3 MJ Carrera,1,3 F Cots,3,4 J Puig de Dou,1 E Corominas,1 J Pedro-Botet,1–3 JA Flores-Le Roux,1–3 C Claret,1 A Goday,1–3 JF Cano1–3 1Department of Endocrinology and Nutrition, Hospital del Mar, 2Department of Medicine, Universitat Autònoma de Barcelona, 3Institut Hospital del Mar d’Investigacions Mèdiques, 4Epidemiology and Evaluation Department, Parc de Salut Mar, Barcelona, Spain Background: The purpose of this prospective cohort study was to compare the costs of day hospital (DH) care for hyperglycemic crisis in elderly diabetic patients with those of conventional hospitalization (CH). Secondary objectives were to compare these two clinical scenarios in terms of glycemic control, number of emergency and outpatient visits, readmissions, hypoglycemic episodes, and nosocomial morbidity. Methods: The study population comprised diabetic patients aged >74 years consecutively admitted to a tertiary teaching hospital in Spain for hyperglycemic crisis (sustained hyperglycemia [>300 mg/dL] for at least 3 days with or without ketosis). The patients were assigned to DH or CH care according to time of admission and were followed for 6 months after discharge. Exclusion criteria were ketoacidosis, hyperosmolar crisis, hemodynamic instability, severe intercurrent illness, social deprivation, or Katz index >D.Results: Sixty-four diabetic patients on DH care and 36 on CH care were included, with no differences in baseline characteristics. The average cost per patient was 1,345.1±793.6 € in the DH group and 2,212.4±982.5 € in the CH group (P<0.001). There were no differences in number of subjects with mild hypoglycemia during follow-up (45.3% DH versus 33.3% CH, P=0.24), nor in the percentage of patients achieving a glycated hemoglobin (HbA1c) <8% (67.2% DH versus 58.3% CH, P=0.375). Readmissions for hyperglycemic crisis and pressure ulcer rates were significantly higher in the CH group.Conclusion: DH care for hyperglycemic crises is more cost-effective than CH care, with a net saving of 1,418.4 € per case, lower number of readmissions and pressure ulcer rates, and similar short-term glycemic control and hypoglycemia rates. Keywords: day hospital, conventional hospitalization, hyperglycemic crisisBenaiges DChillarón JJCarrera MJCots FPuig de Dou JCorominas EPedro-Botet JFlores-Le Roux JAClaret CGoday ACano JFDove Medical Pressarticleday hospitalconventional hospitalizationhyperglycemic crisisGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 843-849 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	day hospital conventional hospitalization hyperglycemic crisis Geriatrics RC952-954.6
spellingShingle	day hospital conventional hospitalization hyperglycemic crisis Geriatrics RC952-954.6 Benaiges D Chillarón JJ Carrera MJ Cots F Puig de Dou J Corominas E Pedro-Botet J Flores-Le Roux JA Claret C Goday A Cano JF Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
description	D Benaiges,1–3 JJ Chillarón,1–3 MJ Carrera,1,3 F Cots,3,4 J Puig de Dou,1 E Corominas,1 J Pedro-Botet,1–3 JA Flores-Le Roux,1–3 C Claret,1 A Goday,1–3 JF Cano1–3 1Department of Endocrinology and Nutrition, Hospital del Mar, 2Department of Medicine, Universitat Autònoma de Barcelona, 3Institut Hospital del Mar d’Investigacions Mèdiques, 4Epidemiology and Evaluation Department, Parc de Salut Mar, Barcelona, Spain Background: The purpose of this prospective cohort study was to compare the costs of day hospital (DH) care for hyperglycemic crisis in elderly diabetic patients with those of conventional hospitalization (CH). Secondary objectives were to compare these two clinical scenarios in terms of glycemic control, number of emergency and outpatient visits, readmissions, hypoglycemic episodes, and nosocomial morbidity. Methods: The study population comprised diabetic patients aged >74 years consecutively admitted to a tertiary teaching hospital in Spain for hyperglycemic crisis (sustained hyperglycemia [>300 mg/dL] for at least 3 days with or without ketosis). The patients were assigned to DH or CH care according to time of admission and were followed for 6 months after discharge. Exclusion criteria were ketoacidosis, hyperosmolar crisis, hemodynamic instability, severe intercurrent illness, social deprivation, or Katz index >D.Results: Sixty-four diabetic patients on DH care and 36 on CH care were included, with no differences in baseline characteristics. The average cost per patient was 1,345.1±793.6 € in the DH group and 2,212.4±982.5 € in the CH group (P<0.001). There were no differences in number of subjects with mild hypoglycemia during follow-up (45.3% DH versus 33.3% CH, P=0.24), nor in the percentage of patients achieving a glycated hemoglobin (HbA1c) <8% (67.2% DH versus 58.3% CH, P=0.375). Readmissions for hyperglycemic crisis and pressure ulcer rates were significantly higher in the CH group.Conclusion: DH care for hyperglycemic crises is more cost-effective than CH care, with a net saving of 1,418.4 € per case, lower number of readmissions and pressure ulcer rates, and similar short-term glycemic control and hypoglycemia rates. Keywords: day hospital, conventional hospitalization, hyperglycemic crisis
format	article
author	Benaiges D Chillarón JJ Carrera MJ Cots F Puig de Dou J Corominas E Pedro-Botet J Flores-Le Roux JA Claret C Goday A Cano JF
author_facet	Benaiges D Chillarón JJ Carrera MJ Cots F Puig de Dou J Corominas E Pedro-Botet J Flores-Le Roux JA Claret C Goday A Cano JF
author_sort	Benaiges D
title	Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
title_short	Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
title_full	Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
title_fullStr	Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
title_full_unstemmed	Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
title_sort	efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/a120cfff67e44c6f95ff9139d3a8a060
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Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital

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