In-hospital Complications Among Survivors of Admission for Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, or Diabetes Mellitus

J Gen Intern Med. 1995 Jun;10(6):307-14. doi: 10.1007/BF02599949.

Abstract

Objective: To determine the frequency of hospital complications among survivors of inpatient treatment for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or diabetes mellitus (DM).

Design: Retrospective cohort study.

Setting: Nine Veterans Affairs hospitals in the southern United States.

Patients: 1,837 men veterans discharged alive following hospitalization for CHF, COPD, or DM between January 1987 and December 1989. This patient population represents a subset of cases gathered to study the process of care in the hospital and subsequent early readmission; thus, veterans who died in the hospital were not included.

Measurements: Medical record review to record the occurrence of any of 30 in-hospital complications such as cardiac arrest, nosocomial infections, or delirium (overall agreement between two reviewers = 84%, kappa = 0.37).

Results: Complications occurred in 15.7% of the CHF cases, 13.1% of the COPD cases, and 14.8% of the DM cases. Hypoglycemic reactions were the most frequent individual adverse events in the CHF and DM cases (3.6% and 11.4% of the cases, respectively), and theophylline toxicity was most frequent among the COPD cases (4.9%). Patient age, the presence of comorbid diseases, and the Acute Physiology Score (APS) of APACHE II were associated with complication occurrence. For each disease, the patients who had a complication had significantly longer mean hospital stays than did the patients who did not have complications (14.6 to 14.9 days vs 7.2 to 8.2 days, p < 0.01).

Conclusions: Complications are frequent among patients discharged alive with CHF, COPD, or DM. The patients who experienced complications were more ill on admission and had longer hospital stays.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Comorbidity
  • Diabetes Complications*
  • Heart Failure / complications*
  • Hospitalization*
  • Hospitals, Veterans / standards
  • Humans
  • Lung Diseases, Obstructive / complications*
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Retrospective Studies
  • United States