Abstract 1708: Hyperglycemia in Heart Failure Patients is Associated With Increased Length of Stay and Costs
Introduction: Hyperglycemia is a well-known marker of poor clinical outcomes in acute myocardial infarction and congestive heart failure (CHF). Recent glucometric studies suggest that the mean blood glucose (MBG) during an admission is the most predictive measurement of glucose metabolism.
Hypothesis: We hypothesized that persistent hyperglycemia is associated with increased length of stay (LOS) and increased total costs in patients admitted with CHF.
Methods: Retrospective charts review for consecutive patients admitted with a primary diagnosis of CHF over a period of 1 year. Demographics, clinical parameters, admission glucose, MBG, history of diabetes, length of stay, total cost and readmission from CHF were abstracted. The MBG values for the entire admission were categorized into two groups: MBG > = 140mg/dL and <140mg/dL.
Results: Of 203 patients studied, there were 56% males, 64% were white, 20% African American, 15% Hispanic, 88% were hypertensive and 49% had prior diabetes. The mean age was 73 years. MBG levels > = 140mg/dL were observed in 39% patients (70% of diabetics and 30% of non- diabetics). Patients in both MBG groups were similar in age, resting EF, and gender. There were more Hispanics (66% vs. 35%; p = 0.001) in the elevated MBG group. Patients with elevated MBG levels had longer LOS (8.1 vs. 5.2 days; p = 0.001) and higher total hospital costs ($21,924 vs. $9,613; p = 0.01). Similarly, prolonged hospital LOS > 7 days (54% vs. 34%; p = 0.008) and total cost > $10,000 per patient (46 % vs. 29%; p = 0.01) were seen more commonly in patients with poor glucometrics. Admission glucose >140mg/dL was not predictive of total costs or LOS. The patients with elevated MBG also had higher readmission rates (51% vs. 37%; p = 0.03). The observed increase in LOS and total costs in patients with elevated MBG were independent of the presence of diabetes. Conclusion: Elevated MBG levels equal or above 140mg/dL, but not admission glucose, was associated with an increased LOS, total hospital costs and readmission rates. Our study emphasizes the need to further examine the role of glycemic control in diabetic and non-diabetic patients admitted with CHF.