Hyperglycemia is associated with increased length of stay and total cost in patients hospitalized for congestive heart failure

Abstract

Objectives: Hyperglycemia is a well-known marker of poorclinical outcomes in acute myocardial infarction and critical illness; however,its effect in congestive heart failure (CHF) is controversial. We hypothesized thatpersistent hyperglycemia is associated with increased length of stay (LOS) andincreased total cost in patients admitted with CHF. Methods: We studied 203 consecutivepatients admitted with a primary diagnosis of CHF. Patient characteristics, admissionglucose, mean blood glucose (MBG) duringthe entire hospital stay, length of stay, total cost, and readmission rates wereassessed. Persistent hyperglycemia was defined as a MBG level ≥140 mg/dl. Results:Patients withpersistent hyperglycemia had longer mean LOS (8.1 vs 5.2 days, p = 0.001) and highertotal hospital costs (median $8940 vs $6892, p = 0.01) independent of diabetesstatus. Similarly, prolonged hospital stay >7 days (38% vs 21%; p = 0.01) andtotal cost >$10,000/patient (46% vs 29%; p = 0.01) were seen more commonly inpatients with poor glucometrics. Neither admission glucose >140 mg/ dL or diabetes status was predictive of total costs or LOS. In multivariate linear regression,only MBG ≥ 140 mg/dl was associated with increased LOS and total cost. Patients with persistent hyperglycemia also had higher6 months all-cause readmission rates (51% vs 37%; p = 0.03). Conclusion: Persistenthyperglycemia (MBG > 140 mg/dL), but not admission glucose, was associatedwith increased LOS, total cost and readmission rates independent of diabetes status.Our study emphasizes the need to further examine the role of glycemic controlin patients admitted with CHF.