Carmen Barbero Linares, José Luis Martín-Conty, Begoña Polonio-López, Cristina Rivera Picón, Juan J Bernal-Jiménez, Francisca Torres Falguera, Joseba Rabanales Sotos, Miguel Antonio Sampedro-Nuñez, Fernando Sebastián-Valles, Miguel Ángel Castro Villamor, Carlos Del Pozo Vegas, Marta Pérez González, Raúl López-Izquierdo, Francisco Martín-Rodríguez, Ancor Sanz-García
{"title":"Emergency department glucose cut-off for 2-year mortality: A multicentre, prospective, cohort study.","authors":"Carmen Barbero Linares, José Luis Martín-Conty, Begoña Polonio-López, Cristina Rivera Picón, Juan J Bernal-Jiménez, Francisca Torres Falguera, Joseba Rabanales Sotos, Miguel Antonio Sampedro-Nuñez, Fernando Sebastián-Valles, Miguel Ángel Castro Villamor, Carlos Del Pozo Vegas, Marta Pérez González, Raúl López-Izquierdo, Francisco Martín-Rodríguez, Ancor Sanz-García","doi":"10.1111/eci.70066","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Admission glucose levels in acute illnesses are critical prognostic biomarkers; yet their impact on long-term outcomes has not been sufficiently studied, particularly in emergency medical services (EMS). This study aims to establish specific glucose cut-off points to predict 2-year mortality in patients treated in emergency departments (ED), stratified by diabetes status (Nondiabetic, Uncomplicated diabetes and Complicated diabetes).</p><p><strong>Methods: </strong>A multicentre, prospective cohort study was conducted, including 5632 adult patients with acute illnesses managed by EMS and admitted to EDs in three Spanish provinces. Patients were classified as nondiabetic, with uncomplicated diabetes, or with diabetes with complications. Multivariable analyses were used to identify predictors of 2-year mortality and determine specific glucose cut-off points.</p><p><strong>Results: </strong>In nondiabetic patients, admission glucose levels showed a U-shaped relationship with 2-year mortality, with key cut-off points at 76.1 and 143 mg/dL. Conversely, no significant association between glucose levels and mortality was observed in diabetic patients. Predictors of mortality included advanced age, high aCCI scores and organ dysfunction in nondiabetics, while diabetic patients exhibited additional alterations related to chronic inflammation and coagulation.</p><p><strong>Conclusion: </strong>Admission glucose levels are a key biomarker for predicting 2-year mortality in nondiabetic patients treated in EDs, emphasizing the importance of maintaining glucose within optimal ranges. These findings support the development of personalised management strategies based on the metabolic and clinical status of patients, optimising resources and outcomes in EMS and EDs.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70066"},"PeriodicalIF":4.4000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/eci.70066","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Admission glucose levels in acute illnesses are critical prognostic biomarkers; yet their impact on long-term outcomes has not been sufficiently studied, particularly in emergency medical services (EMS). This study aims to establish specific glucose cut-off points to predict 2-year mortality in patients treated in emergency departments (ED), stratified by diabetes status (Nondiabetic, Uncomplicated diabetes and Complicated diabetes).
Methods: A multicentre, prospective cohort study was conducted, including 5632 adult patients with acute illnesses managed by EMS and admitted to EDs in three Spanish provinces. Patients were classified as nondiabetic, with uncomplicated diabetes, or with diabetes with complications. Multivariable analyses were used to identify predictors of 2-year mortality and determine specific glucose cut-off points.
Results: In nondiabetic patients, admission glucose levels showed a U-shaped relationship with 2-year mortality, with key cut-off points at 76.1 and 143 mg/dL. Conversely, no significant association between glucose levels and mortality was observed in diabetic patients. Predictors of mortality included advanced age, high aCCI scores and organ dysfunction in nondiabetics, while diabetic patients exhibited additional alterations related to chronic inflammation and coagulation.
Conclusion: Admission glucose levels are a key biomarker for predicting 2-year mortality in nondiabetic patients treated in EDs, emphasizing the importance of maintaining glucose within optimal ranges. These findings support the development of personalised management strategies based on the metabolic and clinical status of patients, optimising resources and outcomes in EMS and EDs.
期刊介绍:
EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.