SHM Converge Scientific Abstract ePoster Gallery-Steroid-Induced Hyperglycemia: A Retrospective Chart Review of Patient Characteristics, Treatment Patterns, and Post-Discharge Outcomes

Steroid-Induced Hyperglycemia: A Retrospective Chart Review of Patient Characteristics, Treatment Patterns, and Post-Discharge Outcomes

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This retrospective chart review examined 265 hospitalized patients age 21 or older with steroid-induced hyperglycemia (SIHG) discharged home from a tertiary care hospital over five years. The study aimed to describe patient characteristics, inpatient treatment patterns, and post-discharge outcomes, including 30- and 60-day readmissions and healthcare contact after discharge.<br /><br />Patients were grouped by insulin status at discharge: newly prescribed insulin, continued insulin, or no insulin. Multivariable logistic regression adjusted for key covariates to assess the effects of discharge insulin status and inpatient endocrinology consultation on outcomes.<br /><br />The cohort had a median age of 59 years, and 58% were male. Treatment patterns varied widely. Nearly half of patients newly started on insulin did not have an up-to-date HbA1c, and only 22% of all patients received an inpatient endocrinology consult. Readmission rates were high overall: 33% at 30 days and 44% at 60 days, though only 9% of 60-day readmissions were directly related to hyperglycemia or hypoglycemia. There was no significant difference in readmission rates based on discharge insulin status.<br /><br />However, inpatient endocrinology consultation was associated with better outcomes, including a significantly lower 60-day readmission rate (odds ratio 0.43, 95% CI 0.21–0.86). Patients discharged on newly prescribed insulin also had more frequent post-discharge glucose-related healthcare contact (37%).<br /><br />The authors concluded that SIHG is associated with substantial readmission burden and inconsistent management practices. They identified low rates of HbA1c assessment and limited documentation of insulin tapering plans in discharge summaries as important areas for improvement.

Asset Subtitle

Kathryn Levy

Meta Tag

Author List Gabrielle Horner, Kathryn Levy, Lynn Ang, Nazanene Esfandiari, Shuo Tian, Stephanie Taylor

Category Research

Concept Steroid-Induced Hyperglycemia

Concept Insulin Therapy

Concept Discharge Insulin Status

Concept Unplanned Readmission

Concept Hospitalization

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Kathryn Levy

Track Transitions of Care

Keywords

steroid-induced hyperglycemia

hospital discharge

readmission

endocrinology consultation

insulin therapy

HbA1c assessment

retrospective chart review

post-discharge outcomes

inpatient management

tertiary care hospital

Steroid-Induced Hyperglycemia

Insulin Therapy

Discharge Insulin Status

Unplanned Readmission

Hospitalization