Iqbal Rabia, Solipuram Divya, Mohammed Yaqub Nadeem, Bajwa Ahmad Taimoor, Irfan Arslan, Jafar Amina, Rehman Zarlish, Islam Zaigham Ul
Medicine, The Brooklyn Hospital Center, Brooklyn, USA.
Internal Medicine, Nassau University Medical Center, East Meadow, USA.
Cureus. 2024 Jul 16;16(7):e64673. doi: 10.7759/cureus.64673. eCollection 2024 Jul.
Aims Hepatocellular carcinoma (HCC) is one of the common liver malignancies that presents a challenge to global healthcare. The impact and outcomes of hypoglycemia in HCC have not been studied in detail before. This study aimed to investigate the outcomes and prognosis associated with hypoglycemia in patients diagnosed with HCC, utilizing a large-scale database approach. Methods Using the Nationwide Inpatient Sample (NIS) database from 2017 to 2020, we conducted a comprehensive retrospective analysis to examine the incidence, risk factors, and clinical implications of hypoglycemia on HCC patients. The patients were divided into two groups: those with hypoglycemia and those without hypoglycemia. Univariate and multivariate logistic regression were used to conduct the analysis. STATA® version 17.0 software (StataCorp LLC, College Station, TX) was used for this purpose. Results Out of a total of 343,895 patients with HCC, the prevalence of hypoglycemia was present in 1.5% of this patient population. We found that hypoglycemia was common in the male population (68%). Compared with patients without hypoglycemia, patients who had hypoglycemia with HCC had higher mortality (42%, p-value < 0.05) and higher risks of secondary outcomes such as hepatic failure, spontaneous bacterial peritonitis (SBP), ascites, and portal vein thrombosis compared to patients who did not have hypoglycemia. The multivariate-adjusted odds ratio for hepatic failure was 2.7 (2.3-3.1), for SBP was 2.9 (1.8-3.0), for ascites was 1.6 (1.4-1.9), and for portal vein thrombosis was 1.2 (0.9-1.4). Conclusion In conclusion, hypoglycemia in HCC is associated with increased mortality and worse outcomes.
目的 肝细胞癌(HCC)是常见的肝脏恶性肿瘤之一,给全球医疗保健带来了挑战。此前尚未对HCC患者低血糖的影响和结局进行详细研究。本研究旨在利用大规模数据库方法,调查确诊为HCC的患者低血糖的结局和预后。方法 我们使用2017年至2020年的全国住院患者样本(NIS)数据库,进行了全面的回顾性分析,以检查低血糖在HCC患者中的发生率、危险因素及临床意义。患者分为两组:有低血糖组和无低血糖组。采用单因素和多因素逻辑回归进行分析。为此使用了STATA® 17.0版软件(StataCorp有限责任公司,德克萨斯州大学城)。结果 在总共343,895例HCC患者中,低血糖患病率在该患者群体中为1.5%。我们发现低血糖在男性群体中常见(68%)。与无低血糖的患者相比,HCC合并低血糖的患者死亡率更高(42%,p值<0.05),与无低血糖的患者相比,发生肝衰竭、自发性细菌性腹膜炎(SBP)、腹水和门静脉血栓形成等次要结局的风险更高。肝衰竭的多因素调整比值比为2.7(2.3 - 3.1),SBP为2.9(1.8 - 3.0),腹水为1.6(1.4 - 1.9),门静脉血栓形成为1.2(0.9 - 1.4)。结论 总之,HCC患者的低血糖与死亡率增加和更差的结局相关。