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dc.contributor.authorSpanakis, E.K.
dc.contributor.authorSingh, L.G.
dc.contributor.authorSiddiqui, T.
dc.date.accessioned2020-05-26T20:41:59Z
dc.date.available2020-05-26T20:41:59Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85084535837&doi=10.1136%2fbmjdrc-2019-000990&partnerID=40&md5=fb7ce0e3139ef0001afae04f68c4910d
dc.identifier.urihttp://hdl.handle.net/10713/12835
dc.description.abstractOBJECTIVE: To evaluate whether increased glucose variability (GV) during the last day of inpatient stay is associated with increased risk of 30-day readmission in patients with diabetes. RESEARCH DESIGN AND METHODS: A comprehensive list of clinical, pharmacy and utilization files were obtained from the Veterans Affairs (VA) Central Data Warehouse to create a nationwide cohort including 1?042?150 admissions of patients with diabetes over a 14-year study observation period. Point-of-care glucose values during the last 24?hours of hospitalization were extracted to calculate GV (measured as SD and coefficient of variation (CV)). Admissions were divided into 10 categories defined by progressively increasing SD and CV. The primary outcome was 30-day readmission rate, adjusted for multiple covariates including demographics, comorbidities and hypoglycemia. RESULTS: As GV increased, there was an overall increase in the 30-day readmission rate ratio. In the fully adjusted model, admissions with CV in the 5th-10th CV categories and admissions with SD in the 4th-10th categories had a statistically significant progressive increase in 30-day readmission rates, compared with admissions in the 1st (lowest) CV and SD categories. Admissions with the greatest CV and SD values (10th category) had the highest risk for readmission (rate ratio (RR): 1.08 (95% CI 1.05 to 1.10), p<0.0001?and RR: 1.11 (95% CI 1.09 to 1.14), p<0.0001 for CV and SD, respectively). CONCLUSIONS: Patients with diabetes who exhibited higher degrees of GV on the final day of hospitalization had higher rates of 30-day readmission. TRIAL REGISTRATION NUMBER: NCT03508934, NCT03877068. Copyright Author(s) (or their employer(s)) 2020.en_US
dc.description.urihttps://doi.org/10.1136/bmjdrc-2019-000990en_US
dc.language.isoen_USen_US
dc.publisherBMJ Publishing Groupen_US
dc.relation.ispartofBMJ open diabetes research & care
dc.subjectepidemiologyen_US
dc.subjecthospitalizationen_US
dc.subjectinpatient diabetes managementen_US
dc.titleAssociation of glucose variability at the last day of hospitalization with 30-day readmission in adults with diabetesen_US
dc.typeArticleen_US
dc.identifier.doi10.1136/bmjdrc-2019-000990
dc.identifier.pmid32398351


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