Outcomes of Hospitalized Patients with Glucocorticoid-Induced Hyperglycemia—A Retrospective Analysis
| Autor: | Tristan Struja, Thaddaeus Muri, Claudine A. Blum, Philipp Schuetz, Beat Mueller, Ciril Baechli, Sandra Gafner, Neele Delfs |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
endocrine system diseases Side effect Hospitalized patients medicine.medical_treatment lcsh:Medicine 030209 endocrinology & metabolism Hypoglycemia Article cardiovascular events 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Clinical endpoint glucocorticoid-induced hyperglycemia 030212 general & internal medicine business.industry Insulin Incidence (epidemiology) lcsh:R nutritional and metabolic diseases General Medicine Odds ratio medicine.disease mortality infection hypoglycemia outcome business Glucocorticoid glucocorticoid-induced diabetes medicine.drug |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 4079, p 4079 (2020) Journal of Clinical Medicine Volume 9 Issue 12 |
| ISSN: | 2077-0383 |
| Popis: | Background: Glucocorticoid (GC)-induced hyperglycemia is a frequent side effect in hospitalized patients. Guidelines recommend treat-to-target treatment between 6&ndash 10 mmol/L (108&ndash 180 mg/dL) with insulin, but data on outcome is scarce. We investigated the 30-day outcome in hospitalized patients receiving GCs. Methods: All patient records of hospitalized patients between January 2014 and April 2018 were screened for GC administration and consecutive hyperglycemia. The primary combined endpoint consisted of death, cardiovascular events, and infections until 30 days after admission. Hypoglycemia was a secondary outcome. Results: Of the 2424 hospitalized patients (9.6% of all hospitalized patients) who received systemic GCs and met inclusion criteria, the overall incidence for GC-induced hyperglycemia was 812 (33.5%), and 89 (3.7%) had at least one documented hypoglycemia during their hospital stay. Compared to patients with normoglycemia, GC-induced hyperglycemia had an adjusted-odds ratio of 1.68 (95% CI 1.25&ndash 2.26) for the combined primary endpoint. Hypoglycemia even had an odds ratio of 1.95 (95% CI 1.2&ndash 3.17). Conclusions: Mortality, cardiovascular events, and rate of infections were markedly higher in patients with GC-induced hyperglycemia as compared to patients with normoglycemia. Importantly, hypoglycemia was associated with a doubled risk for adverse outcome. Future studies should evaluate whether optimized glucose control by minimizing the risk for hypoglycemia has a beneficial effect on clinical outcomes in patients with GC-induced hyperglycemia. |
| Databáze: | OpenAIRE |
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