Yu Xiao, MD

Guangdong Eye Institute,
Department of Ophthalmology,
Guangdong Provincial People’s Hospita,l
Guangdong Academy of Medical Sciences,
The Second School of Clinical Medicine,
Southern Medical University,
China

Prior research indicates that patients with diabetes for at least 20 years will almost always be diagnosed with diabetic retinopathy (DR). Evidence also suggests a high prevalence of DR in China, thus creating the largest DR population in the world. “DR not only threatens the vision and life quality of patients but also brings heavy healthcare and economic burden to their family and society,” wrote Yu Xiao, MD, and colleagues in the Journal of Diabetes Research. “With worldwide population aging and prolonged life expectancy, the prevalence and burden of DR will continue to escalate.”

Dr. Xiao and research team conducted a study to examine the causes and risk factors of repeat hospitalization in patients with DR. In this retrospective study, electronic medical records were examined to identify patients with DR who were readmitted to the hospital between January 1, 2012 and July 31, 2021. Among 1,623 patients, 827 experienced at least two hospital readmissions. These 827 patients were divided into three categories: 2-3 hospitalizations, 4-5 hospitalizations, and >5 hospitalizations.

 

The Impacts of Age & Residence

The researchers used Kruskal-Wallis rank-sum test to indicate that the ages of the patients were significantly different among the three groups examined, with the >5 hospitalizations group having the youngest patient age range (median age, 52). Chi-square test indicated that residency and payment type were also significantly different among the three groups. Indeed, “younger patients with medical insurance and local residence [had] a higher risk of repeated hospitalization,” wrote Dr. Xiao and colleagues.

 

Comorbidities Contribute to Risk

Analysis of 2,592 hospital discharges for 827 patients found that the primary causes for rehospitalization were macular edema (30.83%), hemorrhage (29.09%), cataract (22.76%), proliferative membrane formation (6.91%), silicone oil removal (4.71%), retinal detachment (4.44%), and glaucoma (4.17%).

Comorbidities were found to have an impact on a patient’s length of hospital stay. among participants, the following comorbidities were observed: hypertension (40.28%), diabetic nephropathy (11.65%), chronic kidney disease (4.01%), dyslipidemia (2.70%), stroke (1.93%), and coronary heart disease (1.66%). In-patient fees for patients with comorbid systemic diseases were much higher than those without.

The application of ordinal logistic regression analysis determined that younger age for first hospital admission was a risk factor for a patient’s repeat rehospitalizations (OR, 0.954).

Because of the major health burden that DR poses, Dr. Xiao and colleagues urge intensive patient education to encourage compliance and regular follow-ups with these patients.