Diabetes ketoacidosis (DKA) is a severe endocrine emergency that causes morbidity and death. Readmissions play a major, though often avoidable, role in the USA’s healthcare expense burden. The purpose of this study was to characterise the incidence and features of nonelective 30-day readmission among adult patients with type 1 diabetes mellitus (T1DM) hospitalised for DKA, as well as to identify predictors of readmission. The 2018 Nationwide Readmission Database was used in the study. DKA hospitalizations in T1DM patients were coded using the International Classification of Diseases, Tenth Revision, Clinical Modification. To examine baseline characteristics between readmissions and index hospitalizations, researchers used chi-squared tests. To find independent determinants of readmission, multivariable Cox regression was used. After that, they created a 30-day readmission risk score system based on independent predictors. DKA had a 19.4 percent 30-day all-cause readmission rate. On readmission, the majority of patients had DKA as the primary diagnosis. Patients who were readmitted had a considerably greater mean age and a larger proportion of females than those who were hospitalised the first time. Readmission after DKA was related to an increased risk of inpatient death. Female sex, initial hospitalizations with a Charlson Comorbidity Index (CCI) score of 3 or higher, and being released against medical advice were all independent predictors of 30-day all-cause readmission (AMA).

The readmission rate for DKA in T1DM patients is significant, and DKA is the primary diagnosis in the majority of patients on readmission. A CCI of 3 or higher, hypertension, female gender, and being released AMA were all significant predictors of readmission.

Reference: https://academic.oup.com/jcem/article/106/9/2592/6286993