Background and AimsGiven treatment‐related hypoglycaemia in hospitals can lead to adverse outcomes, the Australian Commission on Safety and Quality in Health Care has included hypoglycaemia as a reportable hospital‐acquired complication (HAC) with financial disincentives. However, the designation of a hypoglycaemia HAC relies on clinical coding without a defined glucose threshold or clinical context. We assessed the biochemical validity and clinical relevance of a hypoglycaemia HAC.MethodsWe performed a retrospective review on patients discharged from the Northern Health hospitals between March and August 2021 who were designated as experiencing a hypoglycaemia HAC. We assessed cases for biochemical validity (glucose <4.0 mmol), clinical context and whether they were treatment‐related (treatment with insulin or sulphonylurea). We then compared this cohort with a hospital‐wide glucometric survey based on a point‐prevalence study to determine the proportion of individuals with hypoglycaemic events that were designated as hypoglycaemia HAC.ResultsTwo hundred fifty‐six admissions were coded as hypoglycaemia HAC. Eleven (4%) did not have a biochemically valid episode. Of the valid cases, 34 (14%) were not treated with any glucose‐lowering medication and 11 (4%) were treated with noninsulin, nonsulphonylurea glucose‐lowering medication. Two hundred admissions (78%) were considered treatment‐related HAC. Of 139 individuals with diabetes identified in the hospital‐wide point‐prevalence study, 25 (18%) had biochemical evidence for hypoglycaemia: 22 were treatment‐related, of which 68% were not coded as HAC.ConclusionGiven safety and cost implications, the designation of hypoglycaemia HAC requires a standardised definition incorporating a biochemical threshold and clinical context. We propose a clinically relevant definition of hypoglycaemia HAC to promote safe diabetes care.
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