Publications by authors named "Janna C Castro"
Purpose: Determine the association between clinical and demographic factors and 30-day readmission risk after pituitary surgery.
Methods: Patients undergoing pituitary surgery between January 2018 and December 2022 were retrospectively reviewed. Cases were extracted from a converged electronic health record that included surgeries performed at the Midwest, Southeast, and Southwest campuses of the same healthcare Enterprise.
Objectives: The aim of this study was to compare outcomes of using intravenous insulin infusion (IVII) therapy for managing hyperglycemia in a non-intensive care unit (ICU) versus an ICU setting.
Methods: We conducted a retrospective analysis on patients who received IVII for hyperglycemia. The analysis compared variables associated with hypoglycemic events while on IVII, and point-of-care blood glucose control and insulin regimens at discharge.
Objective: Automated insulin delivery (AID) systems are a rapidly growing component in the area of continuous subcutaneous insulin infusion (CSII) therapy. As more patients use these systems in the outpatient setting, it is important to assess safety if their use is allowed to continue in the inpatient setting.
Methods: Analysis was conducted of the records of patients using AID technology upon admission to our hospital between June 2020 and December 2022.
Article Synopsis
- Manual data extraction from electronic health records is resource-intensive, and automating this process can alleviate burdens and enhance research capabilities.
- The study assesses the effectiveness of automated data extraction in a large cohort of adult COVID-19 patients, comparing it with traditional manual methods.
- Results show that automated extraction achieves nearly perfect agreement for most categorical variables and very high correlations for continuous variables, indicating its reliability and feasibility.
Background: Hybrid closed-loop (HCL) systems, also known as automated insulin delivery systems, are a rapidly growing technology in diabetes management. Because more patients are using these systems in the outpatient setting, it is important to also assess inpatient safety to determine whether HCL use can be continued when those patients become hospitalized.
Methods: The records of patients using HCL technology on admission to our hospital between June 1, 2020, and June 30, 2021, were analyzed.
Background: The use of inpatient location for the depiction of glycemic control is an alternative approach to the traditional analysis of hospital-derived glucometric data. Our aim was to develop a method of spatial representation and to test for corresponding statistical variation in inpatient glucose control data.
Methods: Point-of-care blood glucose data from inpatients with diabetes mellitus were extracted.
Purpose: The aim of this study was to investigate adherence to a posthypoglycemic event-monitoring policy for inpatients with diabetes mellitus receiving insulin therapy.
Methods: We analyzed point-of-care blood glucose data from noncritically ill inpatients receiving insulin therapy who had a hypoglycemic event (<70 mg/dL glucose) from January 3, 2017, through April 7, 2018. Blood glucose was measured until 2 sequential readings showed hypoglycemia resolution.
Aim: Instrument measurement error (ME) may affect ability of damped trend analysis to forecast inpatient glycemic control.
Materials & Methods: A statistical approach was developed to introduce ME into damped trend analysis algorithm. Point-of-care blood glucose device data were extracted from the laboratory system.
Aim: To determine variables associated with hyperglycemia and insulin therapy in postoperative inpatients with diabetes mellitus following a quality-improvement initiative.
Materials & Methods: Patients with diabetes mellitus following an elective surgical procedure (n = 782; 877 surgical procedures) were selected.
Results: Age, hemoglobin A corticosteroids, insulin therapy and year of surgery were associated (p < 0.
Aim: Apply methods of damped trend analysis to forecast inpatient glycemic control.
Method: Observed and calculated point-of-care blood glucose data trends were determined over 62 weeks. Mean absolute percent error was used to calculate differences between observed and forecasted values.
Aim: High blood glucose levels in the hospital are common among transplant recipients.
Methods: Retrospective analysis, stratified by diagnosis of pretransplant diabetes mellitus (DM).
Results: Of 346 patients, 96 had pretransplant DM (insulin, n = 60; no insulin, n = 36) and 250 did not.
Objective: Assess the impact of guidelines on the care of patients with diabetes undergoing elective surgery.
Methods: A multidisciplinary team developed perioperative guidelines. Overall changes in key measures were evaluated after guidelines were introduced and compared with a historical cohort.
Glucose control can be problematic in critically ill patients. We evaluated the impact of statistical transformation on interpretation of intensive care unit inpatient glucose control data. Point-of-care blood glucose (POC-BG) data derived from patients in the intensive care unit for 2011 was obtained.
View Article and Find Full Text PDFObjective: To assess the impact of an intervention designed to increase basal-bolus insulin therapy administration in postoperative patients with diabetes mellitus.
Methods: Educational sessions and direct support for surgical services were provided by a nurse practitioner (NP). Outcome data from the intervention were compared to data from a historical (control) period.
Objective: The study's objective was to determine the impact of care directed by a specialty-trained nurse practitioner (NP) or physician assistant (PA) on use of basal-bolus insulin therapy and glycemic control in a population of noncritically ill patients with diabetes.
Methods: A retrospective review of diabetes patients evaluated between July 1, 2011 and December 31, 2011 was conducted. Patients cotreated by a specialty-trained NP/PA were compared with patients who did not receive such care.
Objective: To introduce a statistical method of assessing hospital-based non-intensive care unit (non-ICU) inpatient glucose control.
Methods: Point-of-care blood glucose (POC-BG) data from hospital non-ICUs were extracted for January 1 through December 31, 2011. Glucose data distribution was examined before and after Box-Cox transformations and compared to normality.
Objective: The objective was to assess processes of care for patients with diabetes undergoing elective surgery.
Methods: A retrospective review of medical records was conducted to determine frequency of perioperative glucose monitoring, changes in glucose control, and treatment of intraoperative hyperglycemia.
Results: A total of 268 patients underwent 287 elective procedures.
Objective: Our objective was to assess the application of insulin regimens in surgical postoperative patients with diabetes.
Methods: A chart review was conducted of patients with diabetes who were hospitalized postoperatively between January 1 and April 30, 2011. Analysis was restricted to patients hospitalized for ≥3 days and excluded cases with an endocrinology consult.
Background: We reviewed the care of a large cohort of patients with diabetes mellitus on insulin pump therapy who required an inpatient stay.
Methods: Records were reviewed of patients hospitalized between January 1, 2006, and December 31, 2011.
Results: A total of 136 patients using insulin pumps had 253 hospitalizations.
Background: Insulin pump therapy is a complex technology prone to errors when employed in the hospital setting. When patients on insulin pump therapy require hospitalization, practitioners caring for them must decide whether to allow continued pump use. We provide the largest review regarding transitioning insulin pump therapy from the outpatient to inpatient setting.
View Article and Find Full Text PDFBackground And Objectives: Approximately two-thirds of kidney transplant recipients with no previous history of diabetes experience inpatient hyperglycemia immediately after kidney transplant surgery; whether inpatient hyperglycemia predicts future new onset diabetes after transplant (NODAT) is not established.
Design, Setting, Participants, & Measurements: A retrospective study was conducted to determine the risk conferred by inpatient hyperglycemia on development of NODAT within 1 year posttransplant. All adult nondiabetic kidney transplant recipients between June 1999 and January 2008 were included.
Background: This article reviews the performance of our hospital's inpatient insulin pump policy.
Methods: Twenty-five hospital admissions of 21 unique patients receiving outpatient insulin pump therapy were reviewed.
Results: Between November 1, 2005, and November 30, 2006, there were 25 hospital admissions involving 21 patients receiving outpatient insulin pump therapy.
We present an overview of strategies our institution has taken to understand the state of its inpatient diabetes management. We first describe how we utilized information systems to assess inpatient glycemic control and insulin management in noncritically ill patients and discuss our findings regarding mean bedside glucose levels, the prevalence and frequency hypoglycemic and hyperglycemic events, the patterns of insulin therapy, and evidence of inpatient clinical inertia. We also review the development of a survey to determine practitioner attitudes and beliefs about inpatient diabetes.
View Article and Find Full Text PDFObjective: To review first-year results of a clinic-based type 2 diabetes prevention program.
Methods: From January through December 2007, patients with a diagnosis of prediabetes participated in the Diet-Exercise-Activity-Lifestyle program for instruction in lifestyle changes. Physical therapy assessments were retrospectively reviewed to search for symptoms or findings of physical impairments.