Back to Search
Start Over
Hospitalization costs and clinical outcomes in CABG patients treated with intensive insulin therapy
- Source :
- Journal of Diabetes and its Complications. 31:742-747
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known.This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control.Intensive glucose control resulted in lower BG (131.4±14mg/dl-(7.2±0.8mM) vs. 151.6±17mg/dl (8.4±0.8mM, p0.001), a nonsignificant reduction in the median length of stay (LOS, 7.9 vs. 8.5days, p=0.17) and in a composite of perioperative complications including wound infection, bacteremia, acute renal and respiratory failure, major cardiovascular events (42% vs 52%, p=0.10) compared to conservative control. Median hospitalization costs were lower in the intensive group ($39,366 vs. $42,141, p=0.040), with a total cost savings of $3654 (95% CI: $1780-$3723), than conservative control. Resource utilization for radiology (p=0.008), laboratory (p=0.014), consultation service (p=0.013), and ICU utilization (p=0.007) were also lower in the intensive group. Compared to patients without perioperative complications, those with complications had longer hospital length of stay (10.7days vs. 6.7days, p0.001), higher total hospitalization cost ($48,299 vs. $32,675, p0.001), and higher resource utilization units (2745 vs. 1710, p0.001).Intensive glycemic control [BG 100-140mg/dl (5.5-7.8mM)] in patients undergoing CABG resulted in significant reductions in hospitalization costs and resource utilization compared to patients treated with conservative [BG 141-180mg/dl (7.9-10.0mM)] glucose control.
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
Glucose control
Diabetic Cardiomyopathies
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Coronary Artery Disease
030204 cardiovascular system & hematology
03 medical and health sciences
Insulin Infusion Systems
Postoperative Complications
0302 clinical medicine
Endocrinology
Cost Savings
Diabetes mellitus
Diabetes Mellitus
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Insulin
In patient
Coronary Artery Bypass
Hospital Costs
Aged
Glycemic
Academic Medical Centers
business.industry
Perioperative
Length of Stay
Middle Aged
medicine.disease
Surgery
Treatment Outcome
medicine.anatomical_structure
Anesthesia
Costs and Cost Analysis
Cost analysis
Female
Drug Monitoring
business
Diabetic Angiopathies
Artery
Subjects
Details
- ISSN :
- 10568727
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Journal of Diabetes and its Complications
- Accession number :
- edsair.doi.dedup.....1c1baec32161238cdd3a4b0e137271cb