Glucose levels at hospital admission are associated with 5 year mortality

IF 6.1 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
N. Wah Cheung , Patrick McElduff , Greg Fulcher , Sandy Middleton , Roger Chen , Barbara Depczynski , Jeff Flack , Jen Kinsella , Margaret Layton , Mark McLean , Ann Poynten , Katherine Tonks , Chris White , Vincent Wong , David R Chipps
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Abstract

Aim

We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality.

Methods

A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed.

Results

There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes.

Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors.

Conclusion

Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.

入院时的血糖水平与 5 年死亡率有关。
目的:我们旨在确定入院高血糖和低血糖是否与长期死亡率增加有关:我们对急诊科血糖筛查试验的数据进行了事后分析。数据与入院后 5 年内的死亡登记相联系。入院血糖与死亡率之间的关系通过 Cox 回归进行了检验。此外,还对入院后 28 天内的存活者进行了进一步分析:共有 131,322 名患者,其中 38,712 人(29.5%)死亡。平均随访时间为 3-3 ± 1-5 年。与 6-1-8-0 mmol/L 的参考血糖带相比,血糖带越高,死亡率越高,危险比(HR)为 1-44 (95 %CI 1-34-1-55, p 20-0 mmol/L)。HR为1-56(95 %CI 1-46-1-68,p 结论:入院时的高血糖和低血糖与长期死亡率增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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