Impact of the Addition of Beta-Hydroxybutyrate in the 72-Hour Fast Protocol on Hospitalization Duration: A Quality Improvement Report
Authors' conclusion
Adding a BHB >2.7 mmol/L stopping criterion reduced inpatient hospitalization time, medical costs, and patient burden without compromising insulinoma detection. This evidence-based intervention improves patient adherence and more effectively uses hospital resources.
Study context
- Population
- All patients who completed a 72-hour fast at one institution (78% female, mean age 48 ± 17 years)
- Participants
- 64 patients
- Exposure
- Updated 72-hour fast protocol with beta-hydroxybutyrate (BHB) >2.7 mmol/L stopping criterion vs original protocol
- Original protocoln = 34reference
- Revised protocoln = 30
- Outcome
- Fast duration
Methodological detailsbefore-after comparison, single institution
- Before-after comparison
- Single institution
Main finding
As reported in the abstract
After the update: average fast duration (median 53 hours, IQR [39.1, 71.8])
49.7 hours
After the update: fasts ended for BHB >2.7 mmol/L
50%
N = 15
Reduction in cumulative inpatient fasting
376.5 hours
Observational data: associations, not effects.
Further findings
Insulinoma detection
- Insulinoma cases, all developed hypoglycaemia within 43 hours with BHB ≤1.2 mmol/L
- 7
- Missed insulinoma cases
- 0
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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