Old age, comorbidities up risk of dying after severe hypoglycaemia in SG
Older age, presence of multiple comorbidities, and longer length of hospital stay, rather than difference in glycaemic control, were associated with an increased risk of 1-year death following admission with severe hypoglycaemia in patients with diabetes, according to a Singapore study.
The retrospective observational study included 311 patients with diabetes (mean age 70.7 years) who were admitted to hospital after being diagnosed with severe hypoglycaemia at the emergency department of Singapore General Hospital. A total of 70 deaths (22.5 percent) were recorded within 1 year of admission. [EASD 2017, abstract 730]
Compared with patients who lived longer than 1 year after hospitalization for severe hypoglycaemia, those who died within a year were older (69.2 vs 75.3 years; p<0.05) and had more comorbidities as assessed by CCI* (mean score, 4.1 vs 6.0; p<0.05). Patients who died within a year following admission also tended to stay longer in the hospital (10 vs 5 days; p<0.05).
Among the three factors, CCI score was associated with the highest risk of dying within 1 year after admission, followed by age, and length of hospital stay (hazard ratios, 1.57; p<0.001, 1.06; p=0.01, and 1.05; p=0.01, respectively).
In addition, deceased patients had a lower albumin count on admission (30.3 vs 36.2 g/L; p<0.05) and were more likely to have impaired creatinine clearance at <30 mL/min (65.7 percent vs 35.7 percent; p=0.01) compared with those who survived beyond 1 year.
However, levels of HbA1c were not significantly different between survivors and deceased patients (mean, 7.0 percent vs 6.7 percent; p>0.05).
“The high 1 year mortality rate highlighted the vulnerabilities of certain individuals to adverse outcomes,” according to the researchers led by Dr Teh Ming Ming from the Department of Endocrinology in Singapore General Hospital.
“Hence, admission with severe hypoglycaemia has important prognostic implications … [as it] offers the window of opportunity for healthcare professionals to intervene by comprehensively addressing the issue of hypoglycaemia and other health issues especially in the high-risk group of patients,” said Teh and co-authors.
Nonetheless, the researchers also acknowledged that whether hypoglycaemia causes death in the short term could not be determined based on the current data set.