The association between admission glucose levels and outcomes in adults admitted to a tertiary care hospital

McGrade, Patrick; Yang, Shengping; Nugent, Kenneth

doi:10.1080/20009666.2019.1611318

Cited by 10 publications

(14 citation statements)

References 23 publications

(20 reference statements)

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“…A recent observational retrospective study did not find any correlation between mean glucose level, glycemic variability or persistent hyperglycemia and in-hospital mortality in elderly patients with community acquired pneumonia or chronic obstructive pulmonary disease admitted to internal medicine services [ 7 ] as well as according to the RePoSi register disability and not diabetes was a strong predictor of mortality in hospitalized elderly patients with pneumonia [ 8 ]. On the contrary, an association between admission glucose levels and in-hospital mortality and long of hospital stay was found in patients admitted to tertiary care hospital [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Corrao

Nobili

Natoli³

et al. 2021

Acta Diabetol

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Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and < 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.

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Section: Introductionmentioning

confidence: 99%

Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Corrao

Nobili

Natoli³

et al. 2021

Acta Diabetol

View full text Add to dashboard Cite

show abstract

“… Mcgrade et al. (2019) [ 26 ] Retrospective Elevated blood glucose during hospital admission Blood glucose levels in quartiles; <55 mg/dL, 55–140 mg/dL,140–200 mg/dL and >200 mg/dL Highest mortality in quartiles with blood glucose levels <55 mg/dL and >200 mg/dL 4. Lee et al.…”

Section: Methodsmentioning

confidence: 99%

“…Mcgrade et al . [ 26 ] investigated the effect of elevated blood glucose levels at the time of admission with in-hospital mortality and length of hospital stay in 18,478 adults admitted to a University Medical Centre in US. These authors classified blood glucose (mg/dL) levels in the following quartiles of mg/dL; <55, 55–140, 140–200 and > 200.…”

Section: Methodsmentioning

confidence: 99%

“…As discussed previously, Mcgrade et al . [ 26 ] showed that low blood glucose level (<55 mg/dL) is significantly associated with in-hospital mortality. The GLUCONTROL study in which effects of intensive insulin therapy (IIT) was compared with an intermediate glucose control in ICU patients also demonstrated an increased incidence of hypoglycemia in the IIT arm.…”

Section: Methodsmentioning

confidence: 99%

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Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization

Kesavadev

Misra

Saboo

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aims The measurement of vital signs is an important part of clinical work up. Presently, measurement of blood glucose is a factor for concern mostly when treating individuals with diabetes. Significance of blood glucose measurement in prognosis of non-diabetic and hospitalized patients is not clear. Methods A systematic search of literature published in the Electronic databases, PubMed and Google Scholar was performed using following keywords; blood glucose, hospital admissions, critical illness, hospitalizations, cardiovascular disease (CVD), morbidity, and mortality. This literature search was largely restricted to non-diabetic individuals. Results Blood glucose level, even when in high normal range, or in slightly high range, is an important determinant of morbidity and mortality, especially in hospitalized patients. Further, even slight elevation of blood glucose may increase mortality in patients with COVID-19. Finally, blood glucose variability and hypoglycemia in critically ill individuals without diabetes causes excess in-hospital complications and mortality. Conclusion In view of these data, we emphasize the significance of blood glucose measurement in all patients admitted to the hospital regardless of presence of diabetes. We propose that blood glucose be included as the “fifth vital sign” for any hospitalized patient.

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“…Admission glucose levels have significant associations with outcomes in hospitalized patients, and high glucose levels predict increased lengths of stay and increased mortality. 1 , 2 In patients with sepsis, hyperglycemia predicts increased mortality and the development of organ dysfunction. 3 These high glucose levels may identify prehospitalization comorbidity, such as diabetes or adverse effects from drugs such as corticosteroids, and/or can represent an acute stress response associated with severe illness.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Glucose Levels in Patients Hospitalized With COVID-19 During the First Phase of This Pandemic in West Texas

Rao

Ali

Dennis

et al. 2020

J Prim Care Community Health

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Background: Patients with hyperglycemia during hospitalization, especially during ICU hospitalizations, often have worse outcomes, even if they do not have a premorbid diagnosis of diabetes. High glucose levels can provide insight into the underlying pathogenesis of a disease and can contribute to tissue injury. Some patients with COVID-19 have hyperglycemia during hospitalizations. Methods: The Infectious Disease and Control office at University Medical Center in Lubbock, Texas, provided a list of patients with a COVID-19 infection hospitalized between March 1 and May 15, 2020. The medical records were reviewed to collect information on age, gender, history of diabetes, and glucose levels on admission and through the first 7 days of hospitalization. Results: This study included 63 patients with a mean age of 62.1 ± 14.1 years. Thirty-five patients (55.6%) were males. The in-hospital mortality rate was 30.2%. The mean admission glucose level was 129.4 ± 57.1 mg/dL in patients who survived (N = 47) and 189.6 ± 112.2 mg/dL in patients who died during hospitalization (N = 16, P = .007). An admission glucose greater than 180 mg/dL predicted mortality in a model adjusted for a diabetes, age, and male gender. The mean differences between the maximum and minimum glucose levels calculated over the first 7 days of hospitalization were 112.93 ± 115.4 (N = 47) in patients who survived and were 240.5 ± 97.7 (N = 15) in patients who died during hospitalization ( P = .0003). A difference between the maximum and minimum glucose level greater than 105 mg/dL was associated with increased mortality. Conclusions: Patients who died during hospitalization for COVID-19 had higher admission glucose levels than patients who survived. Larger differences between maximum and minimum glucose levels during the first 7 days of hospitalization were associated with increased mortality. These results suggest that high glucose levels identify patients at increased risk for mortality and warrant more study.

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The association between admission glucose levels and outcomes in adults admitted to a tertiary care hospital

Cited by 10 publications

References 23 publications

Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization

Analysis of Glucose Levels in Patients Hospitalized With COVID-19 During the First Phase of This Pandemic in West Texas

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