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The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients.

Publication ,  Journal Article
Buehler, L; Fayfman, M; Alexopoulos, A-S; Zhao, L; Farrokhi, F; Weaver, J; Smiley-Byrd, D; Pasquel, FJ; Vellanki, P; Umpierrez, GE
Published in: J Diabetes Complications
2015

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.

Duke Scholars

Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

2015

Volume

29

Issue

8

Start / End Page

1177 / 1182

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Postoperative Complications
  • Patient Readmission
  • Overweight
  • Obesity
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Length of Stay
 

Citation

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Buehler, L., Fayfman, M., Alexopoulos, A.-S., Zhao, L., Farrokhi, F., Weaver, J., … Umpierrez, G. E. (2015). The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients. J Diabetes Complications, 29(8), 1177–1182. https://doi.org/10.1016/j.jdiacomp.2015.07.027
Buehler, Lauren, Maya Fayfman, Anastasia-Stefania Alexopoulos, Liping Zhao, Farnoosh Farrokhi, Jeff Weaver, Dawn Smiley-Byrd, Francisco J. Pasquel, Priyathama Vellanki, and Guillermo E. Umpierrez. “The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients.J Diabetes Complications 29, no. 8 (2015): 1177–82. https://doi.org/10.1016/j.jdiacomp.2015.07.027.
Buehler L, Fayfman M, Alexopoulos A-S, Zhao L, Farrokhi F, Weaver J, et al. The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients. J Diabetes Complications. 2015;29(8):1177–82.
Buehler, Lauren, et al. “The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients.J Diabetes Complications, vol. 29, no. 8, 2015, pp. 1177–82. Pubmed, doi:10.1016/j.jdiacomp.2015.07.027.
Buehler L, Fayfman M, Alexopoulos A-S, Zhao L, Farrokhi F, Weaver J, Smiley-Byrd D, Pasquel FJ, Vellanki P, Umpierrez GE. The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients. J Diabetes Complications. 2015;29(8):1177–1182.
Journal cover image

Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

2015

Volume

29

Issue

8

Start / End Page

1177 / 1182

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Postoperative Complications
  • Patient Readmission
  • Overweight
  • Obesity
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Length of Stay