Fasting hyperglycaemia and in-hospital mortality in elderly population.
Int J Clin Pract. 2011 Mar;65(3):308-13
Authors: Iglesias P, Polini A, Muñoz A, Dardano A, Prado F, Castiglioni M, Guerrero MT, Tognini S, Macías MC, Díez JJ, Monzani F
Background:? Admission hyperglycaemia has shown to be a marker of poor clinical outcome. The prevalence of admission hyperglycaemia and its relationship with in-hospital mortality in elderly population has not been clearly defined. We assessed the prevalence and prognostic significance of admission fasting hyperglycaemia in aged patients. Methods:? A total of 808 elderly patients were studied. Patients were classified into group I (serum glucose <?126?mg/dl), II (126-180?mg/dl) and III (>?180?mg/dl). Groups II and III were considered newly recognised fasting hyperglycaemia (NRFH) in non-diabetic patients. Results:? NRFH was present in 18.6%. After excluding diabetic patients (n?=?206, 25.5%), the distribution of patients (n?=?602, 74.5%) was as follows: group I (n?=?452, 55.9%), group II (n?=?122, 15.1%) and group III (n?=?28, 3.5%). In the whole cohort, median fasting glucose was lower in patients who survived [105?mg/dl (88-135)] than in those who died [127?mg/dl (93-159), p?<?0.001]. This significant difference was maintained only when non-diabetic patients were considered [100?mg/dl (87-122) vs. 118?mg/dl (92-149), p?<?0.001]. In-hospital mortality rate in groups I, II and III was 8.5%, 14.1% and 22.9%, respectively (p?<?0.001). Mortality rate was 8.4%, 18.0% and 32.1% (p?<?0.001) in groups I, II and III, respectively in non-diabetic population. Both low albumin and high glucose serum concentrations were the only independent risk factors for in-hospital all-cause mortality in non-diabetic patients. Conclusions:? In non-diabetic elderly patients admitted for acute disease, serum glucose concentration is an important, simple and independent predictor of hospital mortality.
PMID: 21314868 [PubMed - in process]