Akirov Amit, Shimon Ilan
Institute of Endocrinology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Institute of Endocrinology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Diabetes Complications. 2016 Jul;30(5):845-51. doi: 10.1016/j.jdiacomp.2016.03.021. Epub 2016 Mar 23.
Evaluate the association between admission blood glucose (ABG) and short and long-term mortality following hospitalization for pneumonia of elderly patients with and without diabetes mellitus (DM).
Observational data derived from the electronic records of hospitalized patients ≥65years, admitted for pneumonia between January 2011 and December 2013. ABG levels were classified to categories: ≤70 (low), 70-110 (normal), 111-140 (mildly elevated), 141-199mg/dl (moderately elevated) and ≥200mg/dl (markedly elevated). Main outcomes were all-cause mortality rates at various time points.
Cohort included 2164 patients, 743 with DM (mean age 81, 53% male) and 1421 without it (mean age 83, 52% male). There was a significant interaction between DM, ABG and mortality (p≤0.05). In patients without DM, compared with normal ABG, in-hospital and 30-day mortality rates (adjusted hazard ratio, 95% CI) were higher with moderately (1.5 and 1.4, respectively, p<0.05) and markedly elevated ABG (2.7 and 1.9, respectively, p<0.05). Long-term results were similar at 12 and 36months (1.3 and 1.8, respectively, p<0.05, for moderately and markedly elevated ABG).
In elderly non-diabetic patients hospitalized for pneumonia, moderately and markedly elevated ABG is associated with increased short- and long-term mortality. In diabetic patients there is no association between ABG and mortality.
评估老年糖尿病（DM）患者和非糖尿病患者因肺炎住院后的入院血糖（ABG）与短期和长期死亡率之间的关联。
观察数据来自2011年1月至2013年12月期间因肺炎入院的≥65岁住院患者的电子记录。ABG水平分为以下几类：≤70（低）、70 - 110（正常）、111 - 140（轻度升高）、141 - 199mg/dl（中度升高）和≥200mg/dl（显著升高）。主要结局是不同时间点的全因死亡率。
队列包括2164例患者，其中743例患有DM（平均年龄81岁，53%为男性），1421例未患DM（平均年龄83岁，52%为男性）。DM、ABG和死亡率之间存在显著交互作用（p≤0.05）。在无DM的患者中，与正常ABG相比，中度（分别为1.5和1.4，p<0.05）和显著升高的ABG（分别为2.7和1.9，p<0.05）的住院和30天死亡率（调整风险比，95%置信区间）更高。12个月和36个月的长期结果相似（中度和显著升高的ABG分别为1.3和1.8，p<0.05）。
在因肺炎住院的老年非糖尿病患者中，中度和显著升高的ABG与短期和长期死亡率增加相关。在糖尿病患者中，ABG与死亡率之间无关联。
