Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20889
Title: Routine HbA1c among hematology and oncology inpatients: Diabetes-status and hospital-outcomes.
Austin Authors: Chiu, Wei-Ling;Churilov, Leonid ;Lim, Chee-Hau;Tan, Alanna ;Nedumannil, Rithin;Lau, Lik-Hui;Lew, Jeremy;Hachem, Mariam;Kong, Alvin;Robbins, Raymond J ;Sutcliffe, Harvey;Lam, Que T ;Lee, Andrew;Djukiadmodjo, Frida;Nanayakkara, Natalie;Zajac, Jeffrey D ;Ekinci, Elif I 
Affiliation: Medicine (University of Melbourne)
University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia
Clinical Informatics Unit, Austin Health, Heidelberg, Victoria, Australia
Pathology
Department of Strategy, Quality & Service Redesign, Austin Health, Heidelberg, Victoria, Australia
Endocrinology
The Florey Institute of Neuroscience and Mental Health
Issue Date: 10-May-2019
Date: 2019-05-10
Publication information: Diabetes Research and Clinical Practice 2019; 152: 71-78
Abstract: Using routine HbA1c measurement to determine the prevalence of diabetes mellitus (known and previously unrecognized) and their hospital outcomes among hematology and oncology inpatients. This was a prospective, observational study. Routine automated HbA1c testing was performed in all hematology and oncology inpatients aged ≥54 years at a tertiary hospital, July 2013-January 2015. The outcome measures were: (i) prevalence of known and previously unrecognized diabetes, and (ii) hospital outcomes: length-of-stay (LOS), intensive-care-unit (ICU) admission, 30-day/18-month readmission, and 18-month mortality. Over the 18-month study period, 1076 inpatients aged ≥54 years were admitted to hematology (n = 298) and oncology (n = 778) units: 21% had known diabetes and 7% had previously unrecognized diabetes. Patients with known diabetes had a longer LOS (IRR: 1.18, 95%CI: 1.02-1.37, p = 0.03), compared to those without diabetes, adjusting for age, hemoglobin level, estimated-glomerular-filtration-rate, admission specialty unit, Charlson's comorbidity index score, and glucocorticoid exposure. No significant differences were observed in ICU admission, 30-day/18-month readmission, and 18-month mortality among patients with known, previously unrecognized and no diabetes (p ≥ 0.05). Approximately one in five hematology or oncology inpatients aged ≥54 years had known diabetes, and one in fourteen had previously unrecognized diabetes. Those with known diabetes had a longer hospital stay. Routine HbA1c measurement is can be useful for identifying previously unrecognized diabetes, particularly among patients with high glucocorticoid exposure. Further study is required to determine cost-effectiveness in screening for unrecognized diabetes and optimal management of these patients.
URI: https://ahro.austin.org.au/austinjspui/handle/1/20889
DOI: 10.1016/j.diabres.2019.05.002
ORCID: 0000-0003-2372-395X
Journal: Diabetes Research and Clinical Practice
PubMed URL: 31082446
Type: Journal Article
Subjects: Hematology inpatients
Hospital outcomes
Known diabetes
Oncology inpatients
Routine HbA1c
Unrecognized diabetes
Appears in Collections:Journal articles

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