Relationships between stress hyperglycemia and illness severity as well as medical expenditure in emergency patients / 中华内分泌代谢杂志

ABSTRACT

Objective To study the relationships between stress hyperglycemia and illness severity and medical expenditure in emergency patients. Methods Totally 6128 consecutive hospitalized patients were enrolled from the emergency department. The clinical data of age, gender, stress hyperglycemia, hospitalization expenditure and rescue condition were compared according to diabetic history [ assigned to diabetes mellitus group ( DM) and non-diabetic mellitus group ( NDM ) ] and categories of the diagnosis. The data was compared by subgroups [ stress hyperglycemia group (SH) and control group (CON)]. Results DM patients had longer hospital stays, higher hospitalization expenditure and rescue rates (all P>0. 01) than NDM patients. In DM and NDM group, SH subgroup had higher inspection and medicine expenses, total costs and rescue rates than CON subgroup (all P>0. 05), and NDM+SH subgroup had the highest total costs and rescue rates. Logistic regression analysis showed that SH was an independentriskfactorforrescueinbothNDM[OR=3.817,95％CI(3.151-4.624)]andDM[OR=2.435,95％CI (1. 634-3. 631)] groups. In cardiovascular, respiratory, digestive, neurological, traumatic, and other disease layers, SH was also an independent risk factor for rescue (all P>0. 05). Multivariate regression analysis showed that SH was an independent determinant for total costs, inspection and medicine expenses and days of hospital stay (βwere7077.608,998.472,3495.271,and0.766respectively,allP>0.01). Amongcardiovascular,digestive,and neurological disease layers, SH was an independent factor responsible for days of hospital stay and total costs ( both P>0. 05). Conclusion In emergency admission patients, patients in SH subgroup were severer and had higher medical expenditure than those in CON subgroup. In stratified diseases layers, SH was an independent risk factor for rescuing and increased hospitalization expenditure. Patients in NDM+SH subgroup had more serious illness and more medical expenditure, compared with those in CON subgroup of NDM and DM group.