Youth with Avoidable DKA—Going from Bad to Worse without NICH
| Autor: | Michael Harris, Samantha A. Barry, Celeste Jenisch, Natalie C. Koskela, Rajkaran Sachdej, David V. Wagner |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Diabetes. 67 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/db18-214-or |
| Popis: | Objective: Novel Interventions in Children’s Healthcare (NICH) was developed for youth with T1D who experience avoidable DKAs. Previous findings suggest that NICH participation is associated with fewer PICU visits, hospital admissions, and DKA events, but interpretation is limited due to possibility of regression to the mean. This study examines whether youth experience fewer acute events during the wait period following referral to NICH. Methods: Retrospective chart reviews were conducted for youth with T1D (n=63) who participated in NICH services. Youth mean age was 14.8 years; 57% were female; and 86% were Caucasian. Mean days prior to referral, on wait list, and during NICH were 365, 129, and 353, respectively. Results were normalized across time points to reflect rate of likely event occurrence during 1 year period. Results: Youth were significantly more likely to experience a PICU stay (p=.03) while waiting for NICH compared to baseline and were significantly less likely to experience a DKA (p=.02) or PICU stay (p=.01) during NICH involvement compared to the wait period. Conclusions: Instead of spontaneously improving after baseline (i.e., regression to the mean), youth referred to NICH experience an increase in acute complications while waiting for services, then improvement during NICH involvement. Perhaps referring providers are identifying factors that suggest further deterioration of health without more intensive services. Disclosure R. Sachdej: None. N.C. Koskela: None. D.V. Wagner: None. S.A. Barry: None. C. Jenisch: None. M.A. Harris: Consultant; Self; Eli Lilly and Company. |
| Databáze: | OpenAIRE |
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