Original Data
| Rev Diabet Stud,
2021,
17(2):50-56 |
DOI 10.1900/RDS.2021.17.50 |
In-Hospital Mortality and Glycemic Control in Patients with Hospital Hyperglycemia
María Paula Russo1, Santiago Nicolas Marquez Fosser2,3, Cristina María Elizondo1, Diego Hernán Giunta1, Nora Angélica Fuentes4, María Florencia Grande-Ratti1,3
1Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
2Clinical and Health Informatics Research Group, McGill University, Montréal, Québec, Canada
3Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
4Centro de Investigaciones Clínicas, Mar del Plata, Argentina
Address correspondence to: María Florencia Grande Ratti, e-mail: maria.grande@hospitalitaliano.org.ar
Manuscript submitted October 18, 2020; resubmitted July 8, 2021; accepted September 20, 2021.
Keywords: hospital hyperglycemia, hospital mortality, stress hyperglycemia, hospital hyperglycemia
Abstract
BACKGROUND: Stress-induced hyperglycemia is a phenomenon that occurs typically in patients hospitalized for acute disease and resolves spontaneously after regression of the acute illness. However, it can also occur in diabetes patients, a fact that is sometimes overlooked. It is thus important to make a proper diabetes diagnosis if hospitalized patients with episodes of hyperglycemia with and without diabetes are studied. AIMS: To estimate the extent of the association between stress-induced
hyperglycemia and in-hospital mortality in patients with hospital hyperglycemia (HH), and to explore potential differences between patients diagnosed with diabetes (HH-DBT) and those with stress-induced hyperglycemia (SH), but not diagnosed with diabetes. METHODS: A cohort of adults with hospital hyperglycemia admitted to a tertiary, university hospital in Buenos Aires, Argentina, was analyzed retrospectively. RESULTS: In the study, 2,955 patients were included and
classified for analysis as 1,579 SH and 1,376 HH-DBT. Significant differences were observed in glycemic goal (35.53% SH versus 25.80% HH-DBT, p < 0.01), insulin use rate (26.66% SH versus 46.58% HH-DBT, p < 0.01), and severe hypoglycemia rate (1.32% SH versus 1.74% HH-DBT, p < 0.01). There were no differences in hypoglycemia rate (8.23% SH versus 10.53% HH-DBT) and hospital mortality. There was no increase in risk of mortality in the SH group adjusted for age, non-scheduled hospitalization, major surgical intervention, critical care, hypoglycemia, oncological disease, cardiovascular comorbidity, and prolonged hospitalization. CONCLUSIONS: In this study, we observed better glycemic control in patients with SH than in those with HH-DBT, and there was no difference in hospital mortality.
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