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ENDO: T1DM Patients With DKA Readmitted Fairly Often

Predictors of readmission include female sex, discharge against medical advice, hypertension, chronic kidney disease, anemia

MONDAY, March 22, 2021 (HealthDay News) -- About one in every five patients with type 1 diabetes mellitus (T1DM) admitted to the hospital with diabetic ketoacidosis (DKA) is readmitted within 30 days, according to a study presented at the annual meeting of The Endocrine Society, held virtually from March 20 to 23.

Hafeez Shaka, M.D., from the John H. Stroger Jr. Hospital of Cook County in Chicago, and colleagues examined the rate and predictors of readmission in adults with T1DM hospitalized for DKA using data from the National Readmission Database for 2017. A total of 91,625 hospitalizations involving adults with T1DM hospitalized for DKA were identified; 91,401 patients were discharged alive.

The researchers found that the 30-day readmission rate was 20.2 percent, and most patients had a principal readmission for DKA. The mortality rate was increased significantly for 30-day readmissions compared with index admissions (risk ratio, 2.06). Readmission was also associated with an increased mean length of stay (1.0 days) and total hospitalization charges ($8,217). Female sex, discharge against medical advice, hypertension, chronic kidney disease, and anemia were independent predictors of readmission (hazard ratios, 1.14, 1.54, 1.28, 1.13, and 1.42, respectively). A lower rate of readmission for DKA was seen in association with obesity and hyperlipidemia (hazard ratios, 0.70 and 0.92, respectively).

"Efforts should be channeled toward identifying the risk factors for readmission in hospitalized adult patients with diabetic ketoacidosis as well as ensuring proper discharge planning to decrease the burden of readmissions," Shaka said in a statement.

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