Elevated Admission Glucose and Mortality in Patients With Acute Pulmonary Embolism

Autor: José Labarère, Marie Méan, Nathalie Scherz, Drahomir Aujesky
Přispěvatelé: Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), BCM, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble
Rok vydání: 2011
Předmět:
Blood Glucose
Male
MESH: Pulmonary Embolism
Research design
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Kaplan-Meier Estimate
MESH: Hospitalization
030204 cardiovascular system & hematology
Logistic regression
0302 clinical medicine
Acute care
030212 general & internal medicine
Original Research
MESH: Aged
MESH: Middle Aged
Clinical Care/Education/Nutrition/Psychosocial Research
Thrombolysis
Middle Aged
3. Good health
Pulmonary embolism
Hospitalization
Female
medicine.medical_specialty
MESH: Diabetes Mellitus
Patient Readmission
MESH: Pennsylvania
03 medical and health sciences
Diabetes mellitus
Internal medicine
Severity of illness
Diabetes Mellitus
MESH: Patient Readmission
Internal Medicine
medicine
Humans
MESH: Kaplan-Meier Estimate
Aged
Advanced and Specialized Nursing
MESH: Humans
business.industry
Odds ratio
Pennsylvania
medicine.disease
MESH: Male
Surgery
Hyperglycemia
MESH: Blood Glucose
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Pulmonary Embolism
MESH: Hyperglycemia
business
MESH: Female
Zdroj: Diabetes Care
Diabetes Care, American Diabetes Association, 2012, 35 (1), pp.25-31. ⟨10.2337/dc11-1379⟩
ISSN: 1935-5548
0149-5992
DOI: 10.2337/dc11-1379
Popis: OBJECTIVE Although associated with adverse outcomes in other cardiopulmonary conditions, the prognostic value of elevated glucose in patients with acute pulmonary embolism (PE) is unknown. We sought to examine the association between glucose levels and mortality and hospital readmission rates for patients with PE. RESEARCH DESIGN AND METHODS We evaluated 13,621 patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (from January 2000 to November 2002). Admission glucose levels were analyzed as a categorical variable (≤110, >110–140, >140–170, >170–240, and >240 mg/dL). The outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to assess the independent association between admission glucose levels and mortality and hospital readmission, adjusting for patient (age, sex, race, insurance, comorbid conditions, severity of illness, laboratory parameters, and thrombolysis) and hospital (region, size, and teaching status) factors. RESULTS Elevated glucose (>110 mg/dL) was present in 8,666 (63.6%) patients. Patients with a glucose level ≤110, >110–140, >140–170, >170–240, and >240 mg/dL had a 30-day mortality of 5.6, 8.4, 12.0, 15.6, and 18.3%, respectively (P < 0.001). Compared with patients with a glucose level ≤110 mg/dL, the adjusted odds of dying were greater for patients with a glucose level >110–140 (odds ratio 1.19 [95% CI 1.00–1.42]), >140–170 (1.44 [1.17–1.77]), >170–240 (1.54 [1.26–1.90]), and >240 mg/dL (1.60 [1.26–2.03]), with no difference in the odds of hospital readmission. CONCLUSIONS In patients with acute PE, elevated admission glucose is common and independently associated with short-term mortality.
Databáze: OpenAIRE
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