Chen Peili, Chen Lili, Zhao Xiaolong, Sun Quanya
Department of Endocrinology, Huashan Hospital Fudan University, Shanghai, China.
Int J Endocrinol. 2021 Jan 12;2021:1513683. doi: 10.1155/2021/1513683. eCollection 2021.
To investigate the association between mean plasma glucose and inhospital death proportion.
We retrospectively collected 162,169 inpatient data in Huashan Hospital from January 2012 to December 2015. Mean plasma glucose was calculated and considered as the average glycemia control during hospitalization. Patients were stratified into six groups according to mean plasma glucose. Nonlinear regression was performed to determine the associations between mean plasma glucose and inhospital death proportion, medical cost, and length of stay. Multivariate logistic regressions were performed to evaluate the relationship of mean plasma glucose and outcomes controlling for confounders including age, gender, and others. Subgroup analyses were performed on basis of whether they were surgical patients, ICU patients, patients with diabetes, or others.
Of the 162,169 hospitalized participants, 53.32% were male and 989 died during hospitalization. Nonlinear regression showed there were positive and significant associations between mean plasma glucose and death proportion, medical cost, and length of stay ( < 0.001 for all). Multivariate logistic regressions showed that, compared with group B, a statistically significant association between mean plasma glucose and predicted outcome was apparent, with the odds ratios (95% confidence interval) of 5.79 (3.51-9.55), 2.85 (2.40-3.38), 6.29 (5.24-7.54), 9.34 (7.51-11.62), and 23.52 (16.64-33.26), for group A, group C, group D, group E, and group F, respectively. There was a U-shaped association between mean plasma glucose and death proportion. Subgroup analyses showed similar associations between mean plasma glucose and death proportion, medical cost, and length of stay as in the whole sample.
There was a U-curve association between mean plasma glucose with inhospital death proportion. Mean plasma glucose was associated positively with medical cost and length of stay.
探讨平均血糖水平与住院死亡比例之间的关联。
我们回顾性收集了2012年1月至2015年12月在华山医院住院的162,169例患者的数据。计算平均血糖水平，并将其视为住院期间的平均血糖控制情况。根据平均血糖水平将患者分为六组。采用非线性回归分析确定平均血糖水平与住院死亡比例、医疗费用及住院时间之间的关联。进行多因素logistic回归分析，以评估平均血糖水平与结局之间的关系，并控制年龄、性别等混杂因素。根据患者是否为外科手术患者、重症监护病房（ICU）患者、糖尿病患者或其他患者进行亚组分析。
在162,169例住院患者中，53.32%为男性，989例在住院期间死亡。非线性回归分析显示，平均血糖水平与死亡比例、医疗费用及住院时间之间存在正相关且具有显著意义（均P<0.001）。多因素logistic回归分析显示，与B组相比，平均血糖水平与预测结局之间存在统计学显著关联，A组、C组、D组、E组和F组的比值比（95%置信区间）分别为5.79（3.51 - 9.55）、2.85（2.40 - 3.38）、6.29（5.24 - 7.54）、9.34（7.51 - 11.62）和23.52（16.64 - 33.26）。平均血糖水平与死亡比例之间呈U型关联。亚组分析显示，平均血糖水平与死亡比例、医疗费用及住院时间之间的关联与全样本相似。
平均血糖水平与住院死亡比例之间呈U型曲线关联。平均血糖水平与医疗费用及住院时间呈正相关。
