Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness

Munoz, Fernando A; Chin, Cindy; Kops, Samantha; Kowalek, Katie; Seckeler, Michael D.

doi:10.1515/jpem-2020-0373

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…In one retrospective study, it was noted that children with DKA or severe diabetes having chronic psychiatric illnesses ended up with longer hospital stays and more hospital charges [ 33 ]. A study that looked into readmissions noted that in patients younger than 35 years, the odds for a readmission were increased in those with depression and substance or alcohol abuse [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population

Vasireddy¹,

Sehgal²,

Amritphale³

2021

Cureus

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Background There has been a steady rise in types 1 and 2 diabetes mellitus among the youth in the USA from 2001 to 2017. Diabetic ketoacidosis (DKA) is a common and preventable presentation of both types of diabetes mellitus. According to the Centers for Disease Control and Prevention’s (CDC) United States Diabetes Surveillance System, during 2004-2019 an increase in DKA hospitalization rates by 59.4% was noted, with people aged less than 45 years having the highest rates. Readmissions reflect the quality of disease management, which is integrally tied to care coordination and communication with the patient and their families. This study analyzes the trends and risk factors contributing to 30-day unplanned DKA readmissions in the pediatric age group and looks into possible preventive measures to decrease them. Methods A retrospective study was performed using the National Readmission Database (NRD) from January 1, 2017, to December 1, 2017. Pediatric patients aged 18 years and younger with the primary diagnosis of DKA were included using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code E10.10. All statistical analysis was performed using IBM SPSS Statistics for Windows, version 1.0.0.1327 (IBM Corp., Armonk, NY, USA). Pearson’s chi-square test was used for categorical variables and Mann-Whitney U test was used for continuous variables. To independently determine the predictors of readmission within each clinical variable, multiple logistic regressions with values presented as odds ratios (OR) with 95% confidence intervals (CI) were performed. Results A weighted total of 19,519 DKA-related pediatric index admissions were identified from the 2017 NRD. Of these pediatric patients, 831 (4.3%) had 30-day DKA readmission. The median age of a child for readmission was 16 years with an interquartile range of 0 to 18 years. A sharp rise in 30-day DKA readmissions was noted for ages 16 years and over. Females in the 0-25th percentile median household income category, with Medicaid covered, large metropolitan areas with at least 1 million residents, and metropolitan teaching hospitals were found to have a statistically significant higher percentage of readmissions. The mean length of stay for those who had a DKA readmission was 2.06 days, with a standard deviation of 1.84 days. The mean hospital charges for those who had a DKA readmission were $ 20,339.70. The 30-day DKA readmission odds were seen to be increased for female patients, Medicaid-insured patients, admissions at metropolitan non-teaching hospitals, and children from 0-25th percentile median household income category. Conclusion There has not been much of a change in the trend and risk factors contributing to the 30-day unplanned DKA readmissions over the years despite the steady rise in cases of diabetes mellitus. The length of stay for those who did not get readmitted within 30 days was longer than for those who did. This could ...

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Section: Discussionmentioning

confidence: 99%

Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population

Vasireddy¹,

Sehgal²,

Amritphale³

2021

Cureus

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Diabetes and Mental Health

Robinson¹,

Hanson²,

Jain³

et al. 2023

Canadian Journal of Diabetes

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Diabetes Mellitus Type 1 During COVID-19: Psychological Symptoms and Eating Attitudes

Benioudakis

Karlafti

Georgiou

et al. 2023

CDR

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Background: Diabetes Mellitus Type 1 is a chronic metabolic disorder the treatment of which extremely burdens the patient. The lockdown, as a measure to prevent the spreading of the 2019 corona virus disease, was a major challenge for the general public. People with chronic diseases, such as T1D patients, have complex emotional and psychological needs and are at increased risk for both depressive symptoms and anxiety. Objective: The aim of this study was to evaluate the impact of body mass index of T1D patients on the psychological symptoms and eating habits, as well as the prognostic factors of the psychological symptoms during the lockdown period. Method: Diabetes mellitus patients were invited to complete this survey from the outpatient Diabetes clinic of the General Hospital of Chania and the “AHEPA” General University Hospital of Thessaloniki in Greece. Psychological symptoms were assessed using the DASS-42 questionnaire and eating habits were assessed using the EAT-26 questionnaire. Results: Overall, 112 T1D patients were analyzed (response rate: 28.8%). Obese T1D patients appear to be at greater risk of developing psychological symptoms such as depression, anxiety, and stress. Furthermore, disordered eating behaviors and bulimia and food preoccupation subscale were associated with psychological symptoms. Conlcusion: The findings suggested that obese T1D patients are at greater risk of developing psychological symptoms and an eating disorder is being triggered to reduce the negative psychological symptoms. The results of this study may guide targeted interventions among T1D patients.

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Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness

Cited by 3 publications

References 21 publications

Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population

Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population

Diabetes and Mental Health

Diabetes Mellitus Type 1 During COVID-19: Psychological Symptoms and Eating Attitudes

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