Stress-induced hyperglycemia on complications in non-critically elderly hospitalized patients
Por:
Carrasco-Sánchez FJ, Carretero-Gómez J, Gómez-Huelgas R, Garcia-Ordoñez MA, Pardo-Ortega MV, de Escalante-Yanguela B, Mateos-Polo L, Formiga F and Ena J
Publicada:
1 jun 2018
Categoría:
Medicine (miscellaneous)
Resumen:
Aims: Hospital complications and hyperglycemia are common in elderly
patients during hospitalization. Our aim was to analyze the relationship
between hyperglycemia and hospital complications in an ageing
population.
Methods: We conducted an observational study to evaluate the association
between maximum blood glucose (MBG) levels and hospital complications.
Patients were stratified according to the quartiles of MBG levels.
Diabetes mellitus (DM) was determined by patient history and/or
admission glycated hemoglobin (HbA1c) level >= 6.5%. Hyperglycemia in
patients without DM was defined as stress-induced hyperglycemia (SH).
The composite primary end-point included frequent complications and/or
all-cause hospital mortality.
Results: Among 461 patients, mean age 80 +/- 7.5 years, 238 (51.6%)
patients had DM, 20 had undiagnosed DM, and 162 (35.1%) developed
hospital complications. Patients with complications had higher mean
daily BG levels (215 +/- 84 vs 195 +/- 85 mg/d1, P<.01). The incidence
of complications was directly associated with severity of hyperglycemia
according to the quartiles of MBG levels in patients without DM, namely
SH (< 140 mg/dl, 22.2%; 140-185 mg/dl, 40%; 186-250 mg/dl, 47%; > 250
mg/dl, 60%; P=.002), but not in patients with DM (< 140 mg/dl, 26.3%;
140-185 mg/d1, 40.4%; 186-250 mg/dl, 35.6%; > 250 mg/dl, 37.4%; P=.748).
In the multivariate analyses, SH was independently associated with
complications: OR 2.60 (CI 95%: 1.2-5.6), 2.82 (CI 95%: 1.2-6.5), 5.50
(CI 95%: 1.4-20.8) for the second, third and fourth quartile
respectively (P=.01), as compared to the first quartile. We found no
association with readmissions and all-cause mortality.
Conclusions: SH in elderly patients is associated with hospital
complications, but not with all cause mortality, compared to patients
with diabetes or normoglycennia. (C) 2018 Elsevier Espana, S.L.U. and
Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Filiaciones:
Carrasco-Sánchez FJ:
Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, España
Carretero-Gómez J:
Servicio de Medicina Interna, Hospital de Zafra, Zafra, Badajoz, España
Gómez-Huelgas R:
Servicio de Medicina Interna, Hospital Regional Universitario, Málaga, España
CIBER de Fisiopatología de la Obesidad y la Nutrición, España
Garcia-Ordoñez MA:
Hospital de Antequera, Antequera, Málaga, España
Pardo-Ortega MV:
Hospital de Terrassa, Terrassa, Barcelona, España
de Escalante-Yanguela B:
Hospital Clínico Lozano-Blesa, Zaragoza, España
Mateos-Polo L:
Hospital Virgen de la Vega, Salamanca, España
Formiga F:
Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
:
Hospital de la Marina Baixa, la Vila Joiosa, Alicante, España
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