High glucose variability tied to increased mortality in hospitalized patients
Elevated glucose variability (GV) appears to prolong hospitalization and increase short- and long-term mortality in hospitalized patients with and without diabetes mellitus, reports a recent study.
Researchers assessed GV by coefficient of variance (CV) and standard deviation (SD) of glucose values during hospitalization to examine the association between GV and hospital length of stay (LOS) and mortality. Historical data of patients (aged ≥18 years) hospitalized between January 2011 and December 2013 were collected. The main outcomes were LOS, and in-hospital and mortality at end of follow-up.
Of the 20,303 patients (51 percent men) included and followed for a median of 1,022 days, 8.565 (42 percent) had DM. In patients with or without DM, higher CV or SD tertiles were associated with longer mean LOS.
In-hospital mortality was 8.2 percent in patients without DM with higher tertiles of CV (4, 10 and 19 percent) and SD (4, 11, 21 percent) and in those with DM (3, 5, 10 percent and 2, 4, 9 percent, respectively). Additionally, mortality at the end of follow-up was elevated in patients without DM with higher CV (28, 42, 55 percent) and SD (28, 44, 57 percent) tertiles and in patients with DM (26, 35, 45 percent and 25, 34, 44 percent, respectively).
The risk for in-hospital and end of follow-up mortality increased in both groups, based on multivariate analysis. Results were not affected by adjustment for glucocorticoid treatment or hypoglycaemia.
Two independent factors that affect LOS and in-hospital mortality were GV and glucose levels during hospitalization. In each CV tertile, median glucose ≥180 mg/dL, compared with <180 mg/dL, resulted in higher mortality.
“GV is common among hospitalized patients, but the prognostic implications are not understood,” researchers said.