The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients
Copyright © 2015 Elsevier Inc. All rights reserved..
BACKGROUND: The impact of obesity on clinical outcomes and hospitalization costs in general surgery patients with and without diabetes (DM) is unknown.
MATERIALS AND METHODS: We reviewed medical records of 2451 patients who underwent gastrointestinal surgery at two university hospitals. Hyperglycemia was defined as BG ≥140 mg/dl. Overweight was defined by body mass index (BMI) between 25-29.9 kg/m(2) and obesity as a BMI ≥30 kg/m(2). Hospital cost was calculated using cost-charge ratios from Centers for Medicare and Medicaid Services. Hospital complications included a composite of major cardiovascular events, pneumonia, bacteremia, acute kidney injury (AKI), respiratory failure, and death.
RESULTS: Hyperglycemia was present in 1575 patients (74.8%). Compared to patients with normoglycemia, those with DM and non-DM with hyperglycemia had higher number of complications (8.9% vs. 35.8% vs. 30.0%, p<0.0001), longer hospital stay (5 days vs. 9 days vs. 9 days, p<0.0001), more readmissions within 30 days (9.3% vs. 18.8% vs. 17.2%, p<0.0001), and higher hospitalization costs ($20,273 vs. $79,545 vs. $72,675, p<0.0001). In contrast, compared to normal-weight subjects, overweight and obesity were not associated with increased hospitalization costs ($58,313 vs. $58,173 vs. $66,633, p=0.74) or risk of complications, except for AKI (11.9% vs. 14.8% vs. 20.5%, p<0.0001). Multivariate analysis revealed that DM (OR=4.4, 95% CI=2.8,7.0) or perioperative hyperglycemia (OR=4.1, 95% CI=2.7-6.2) were independently associated with increased risk of complications.
CONCLUSION: Hyperglycemia but not increasing BMI, in patients with and without diabetes undergoing gastrointestinal surgery was associated with a higher number of complications and hospitalization costs.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Journal of diabetes and its complications - 29(2015), 8 vom: 09. Nov., Seite 1177-82 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Buehler, Lauren [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 12.09.2016 Date Revised 01.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jdiacomp.2015.07.027 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM252608771 |
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| 041 | |a eng | ||
| 100 | 1 | |a Buehler, Lauren |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 12.09.2016 | ||
| 500 | |a Date Revised 01.07.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The impact of obesity on clinical outcomes and hospitalization costs in general surgery patients with and without diabetes (DM) is unknown | ||
| 520 | |a MATERIALS AND METHODS: We reviewed medical records of 2451 patients who underwent gastrointestinal surgery at two university hospitals. Hyperglycemia was defined as BG ≥140 mg/dl. Overweight was defined by body mass index (BMI) between 25-29.9 kg/m(2) and obesity as a BMI ≥30 kg/m(2). Hospital cost was calculated using cost-charge ratios from Centers for Medicare and Medicaid Services. Hospital complications included a composite of major cardiovascular events, pneumonia, bacteremia, acute kidney injury (AKI), respiratory failure, and death | ||
| 520 | |a RESULTS: Hyperglycemia was present in 1575 patients (74.8%). Compared to patients with normoglycemia, those with DM and non-DM with hyperglycemia had higher number of complications (8.9% vs. 35.8% vs. 30.0%, p<0.0001), longer hospital stay (5 days vs. 9 days vs. 9 days, p<0.0001), more readmissions within 30 days (9.3% vs. 18.8% vs. 17.2%, p<0.0001), and higher hospitalization costs ($20,273 vs. $79,545 vs. $72,675, p<0.0001). In contrast, compared to normal-weight subjects, overweight and obesity were not associated with increased hospitalization costs ($58,313 vs. $58,173 vs. $66,633, p=0.74) or risk of complications, except for AKI (11.9% vs. 14.8% vs. 20.5%, p<0.0001). Multivariate analysis revealed that DM (OR=4.4, 95% CI=2.8,7.0) or perioperative hyperglycemia (OR=4.1, 95% CI=2.7-6.2) were independently associated with increased risk of complications | ||
| 520 | |a CONCLUSION: Hyperglycemia but not increasing BMI, in patients with and without diabetes undergoing gastrointestinal surgery was associated with a higher number of complications and hospitalization costs | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Hospitalization costs | |
| 650 | 4 | |a Inpatient hyperglycemia | |
| 650 | 4 | |a Obesity | |
| 650 | 4 | |a Obesity paradox | |
| 650 | 4 | |a Type 2 diabetes | |
| 700 | 1 | |a Fayfman, Maya |e verfasserin |4 aut | |
| 700 | 1 | |a Alexopoulos, Anastasia-Stefania |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Liping |e verfasserin |4 aut | |
| 700 | 1 | |a Farrokhi, Farnoosh |e verfasserin |4 aut | |
| 700 | 1 | |a Weaver, Jeff |e verfasserin |4 aut | |
| 700 | 1 | |a Smiley-Byrd, Dawn |e verfasserin |4 aut | |
| 700 | 1 | |a Pasquel, Francisco J |e verfasserin |4 aut | |
| 700 | 1 | |a Vellanki, Priyathama |e verfasserin |4 aut | |
| 700 | 1 | |a Umpierrez, Guillermo E |e verfasserin |4 aut | |
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