Hyperglycemia in hospital: an independent marker of infection, acute kidney injury & stroke for hospital inpatients.
J Clin Endocrinol Metab
; 2024 Jan 27.
Article
em En
| MEDLINE
| ID: mdl-38279945
ABSTRACT
CONTEXT Hyperglycemia in hospital inpatients without pre-existing diabetes is associated with increased mortality. However, the independent contribution of hyperglycemia to healthcare-associated infection (HAI), acute kidney injury (AKI), and stroke is unclear. OBJECTIVE:
To investigate the relationship between hyperglycemia and adverse clinical outcomes in hospital for patients with and without diabetes.DESIGN:
Diabetes IN-hospital Glucose and Outcomes (DINGO) was a 26-week (October 2019 - March 2020) prospective cohort study. Clinical and glucose data were collected up to the 14th day of admission. Primary stratification was by hyperglycemia, defined as ≥2 random capillary blood glucose (BG) measurements ≥11.1â mmol/L (≥200â mg/dL). Propensity weighting for nine clinical characteristics, was performed to allow interrogation of causality. To maintain the positivity assumption, patients with HbA1c > 12.0% were excluded and pre-hospital treatment not adjusted for.SETTING:
The Royal Melbourne Hospital, a quaternary referral hospital in Melbourne, Australia. PATIENTS Admissions with at least two capillary glucose values and length of stay >24â hours were eligible, with half randomly sampled. OUTCOMEMEASURES:
HAI, AKI, stroke, and mortality.RESULTS:
Of 2,558 included admissions, 1,147 (45%) experienced hyperglycemia in hospital. Following propensity-weighting and adjustment, hyperglycemia in hospital was found to, independently of nine covariables, contribute an increased risk of in-hospital HAI (130 [11.3%] vs.100 [7.1%], adjusted odds ratio [aOR] 1.03, 95% confidence interval [95%CI] 1.01-1.05, p = 0.003), AKI (120 [10.5%] vs. 59 [4.2%], aOR 1.07, 95%CI 1.05-1.09, p < 0.001), and stroke (10 [0.9%] vs. 1 [0.1%], aOR 1.05, 95%CI 1.04-1.06, p < 0.001).CONCLUSIONS:
In hospital inpatients (HbA1c ≤ 12.0%), irrespective of diabetes status and pre-hospital glycaemia, hyperglycemia increases the risk of in-hospital HAI, AKI, and stroke compared with those not experiencing hyperglycemia.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália