Association between blood glucose level and outcomes in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease.

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Association between blood glucose level and outcomes in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease.

WMJ. 2013 Dec;112(6):244-9; quiz 250

Authors: Kasirye Y, Simpson M, Mamillapalli CK, Epperla N, Liang H, Yale SH

Abstract
BACKGROUND: Increased blood glucose is associated with adverse clinical outcomes among patients with major illnesses. This study examined the association between blood glucose and adverse outcomes among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease, for which limited prior data were available.
METHODS: We studied a cohort of 209 hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease. Univariate analyses and multivariate logistic regression analyses with backward elimination method were performed to evaluate factors associated with in-hospital complications, length of hospitalization, 30-day hospital readmission, and 90-day all-cause mortality.
RESULTS: Multivariate logistic regression analysis with backward elimination method revealed that lower blood glucose and age at hospital admission were the most significant risk factors for in-hospital complication. Received respiratory support and in-hospital complications were the most significant risk factors for the length of hospitalization. There were no significant risk factors associated with 30-day hospital readmission and 90-day all-cause mortality.
CONCLUSION: The analyses failed to reveal significant associations between higher blood glucose levels and adverse outcomes. We showed that lower glucose levels (hypoglycemia) results in higher risk for in-hospital complications. In-hospital complications results in longer length of hospitalization, which implies that lower glucose levels (hypoglycemia) indirectly may result in longer length of hospitalization. More studies are needed to better clarify the cause for these associations.

PMID: 24511864 [PubMed - indexed for MEDLINE]

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