Association between dysglycemia and the Charlson Comorbidity Index among hospitalized patients with diabetes |
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| Affiliation: | 1. Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada;2. Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA;3. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada;4. Department of Medicine, Division of Endocrinology and Metabolism, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;5. Research Division, Joslin Diabetes Center, Boston, MA, USA;6. Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Ontario, Canada;7. Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada;8. Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada;9. Division of Nephrology, College of Medicine, King Saud University, Riyadh, Saudi Arabia;1. Department of Clinical Laboratory, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, Zhejiang, People''s Republic of China;2. Department of Endocrinology and Metabolism, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, Zhejiang, People''s Republic of China;3. Department of Blood Transfusion, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, Zhejiang, People''s Republic of China;1. Department of Endocrinology, Diabetes and Metabolic Disease, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia;2. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia;3. School of Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Italy;1. Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece;2. Laboratory of Clinical Chemistry, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece;3. Department of Internal Medicine, General Hospital of Ioannina “G. Hatzikosta”, Ioannina, Greece;1. Department of Genetics, Osmania University, Hyderabad, India;2. School of Sciences, Maulana Azad National Urdu University, Hyderabad, India |
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| Abstract: | AimInpatient dysglycemia has been linked to short-term mortality, but longer-term mortality data are lacking. Our aim was to evaluate the association between inpatient dysglycemia and one-year mortality risk.MethodsRetrospective chart review of adults with diabetes hospitalized between 2015 and 2019. The Charlson Comorbidity Index (CCI) was used to estimate 1-year mortality risk, stratified into low (CCI ≤ 5) and high risk (CCI ≥6). Simple and multivariable logistic regression was used to evaluate the association between dysglycemic measures and high mortality risk.ResultsAmong 22,639 unique admissions, BG ≥ 180, ≥300, ≤70, <54 and <40 mg/dL were associated with adjusted odds of 1.43 (95 % CI, 1.33, 1.54), 1.58 (95 % CI, 1.48, 1.68), 2.16 (95 % CI, 2.01, 2.32), 2.58 (95 % CI, 2.32, 2.86), and 2.56 (95 % CI, 2.19, 2.99) for high mortality risk, respectively. Older age and Black race were positively associated with hyperglycemia and hypoglycemia. Myocardial infarction, congestive heart failure (CHF), and moderate to severe liver disease were most strongly associated with hyperglycemia, while renal disease, CHF, peripheral vascular disease, and peptic ulcer disease were most strongly associated with hypoglycemia.ConclusionsInpatient hypoglycemia and hyperglycemia were both positively associated with higher one-year mortality risk, with stronger magnitude of association observed for hypoglycemia. The association appears to be mediated mainly by presence of diabetes-related complications. |
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