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[医院低血糖的预后价值]

[Prognostic value of hospital hypoglycemia].

作者信息

Russo María Paula, Pagotto Vanina L, Burgos Mariana A, Ruiz Angélica B, Cardone María Belén, Grande Ratti María Florencia

机构信息

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina. E-mail:

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2023;83(1):3-9.

Abstract

BACKGROUND

Hospital hypoglycemia (HH) is an important problem since it is linked to hospital death, prolonged stay and higher costs, both in people with and without diabetes, in the critical area and general ward, especially in cases of severe hypoglycemia. The objective of our work was to compare hospital mortality, transfer to the critical area and hospitalization periods in adults with HH according to its severity.

METHODS

We conducted a retrospective cohort of adults hospitalized with hypoglycemia at the Hospital Italiano de Buenos Aires between 2013 and 2018. Three groups of hypoglycemia were defined: mild (glycemia between 70 and 54 mg/dl), severe (glycemia < 54 mg/dl and = 40 mg/dl) and critical (glycemia < 40mg/dl).

RESULTS

A total of 5994 patients had HH, the majority presented mild hypoglycemia (72%). Severe and critical hypoglycemia, compared with mild hypoglycemia, were associated with higher mortality: OR 2.6 (95%CI 2.2-3.1) and 4.2 (95%CI 3.5-5.0) respectively; and increased hospitalization in critical care areas: OR 1.6 (95%CI 1.4-1.9) and 3.2 (95%CI 2.6-4.0) respectively. There were no differences in length of stay.

DISCUSSION

This information provides, in our country, evidence on the prognostic value of hypoglycemia, whose greater severity is associated with increased hospitalization in critical areas and higher hospital mortality.

摘要

背景

医院低血糖(HH)是一个重要问题,因为它与医院死亡、住院时间延长和费用增加有关,无论患者有无糖尿病,在重症区和普通病房均如此,尤其是在严重低血糖的情况下。我们研究的目的是根据低血糖的严重程度比较成人HH患者的医院死亡率、转入重症区情况和住院时间。

方法

我们对2013年至2018年在布宜诺斯艾利斯意大利医院住院的低血糖成人患者进行了一项回顾性队列研究。定义了三组低血糖:轻度(血糖在70至54mg/dl之间)、重度(血糖<54mg/dl且≥40mg/dl)和危急(血糖<40mg/dl)。

结果

共有5994例患者发生HH,大多数为轻度低血糖(72%)。与轻度低血糖相比,重度和危急低血糖与更高的死亡率相关:比值比分别为2.6(95%置信区间2.2 - 3.1)和4.2(95%置信区间3.5 - 5.0);在重症监护区的住院时间增加:比值比分别为1.6(95%置信区间1.4 - 1.9)和3.2(95%置信区间2.6 - 4.0)。住院时间无差异。

讨论

这些信息为我国提供了关于低血糖预后价值的证据,低血糖的严重程度越高,与重症区住院时间增加和医院死亡率升高相关。

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