Predictive value of admission glycemia in diabetics with pulmonary embolism compared to non-diabetic patients.

ABSTRACT

AIMS: To examine the relationship between admission glucose (AG) level and short-term in-hospital mortality and to investigate the association between hyperglycemia and major bleeding in PE patients with and without DMT2. METHODS: We evaluated 1165 patients with diagnosed acute PE with multi-detector computed tomography pulmonary angiography (MDCT-PA) enrolled in the Regional multicenter PE registry (REPER). The study population was classified to patients with diabetes mellitus type 2 (DMT2) and those without diabetes. According to quartiles of AG patients, both groups separately were categorized into four subgroups (DMT2 I < 7.5 mmol/L; II 7.5-10.0 mmol/L; III 10.0-15.7 mmol/L; IV > 15.7 mmol/L and (non-DMT2 I < 5.5 mmol/L; II 5.5-6.3 mmol/L; III 6.3-7.9 mmol/L; IV > 7.9 mmol/L). RESULTS: All-cause mortality was higher in the DMT2 group (9.5% vs. 18.2%, p < 0.001), and PE-cause mortality was 6% for the patients without DMT2 and 12.4% for DMT2 patients (p = 0.02). The patients in the fourth AG quartiles in both groups, without DMT2 and with DMT2, had significantly higher all-cause and PE-cause in-hospital mortality compared with the first quartile. Rates of major bleeding were similar between the groups. On the multivariable analysis, after adjusting for age, gender and mortality risk, the adherence in the fourth AG quartile had an independent predictive value for all-cause death (HR 2.476, 95% CI 1.017-6.027) only in DM patients. CONCLUSION: In our cohort of patients with acute PE, diabetes was associated with increased rates for all-cause and PE-cause mortality.