Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; NHC Key Laboratory of Hypertension Clinical Research; Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory"; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, People's Republic of China.
J Int Med Res. 2024 Nov;52(11):3000605241291742. doi: 10.1177/03000605241291742.
Admission hyperglycaemia is recognized as a contributor to poor outcomes in patients with cardiovascular and cerebrovascular diseases. This study aimed to evaluate the association between admission hyperglycaemia and in-hospital mortality in patients with hypertension and acute aortic dissection (AAD).
Patients diagnosed with hypertension and AAD between 1 January 2010 and 1 March 2023 were enrolled into this retrospective observational study, and divided into two groups based on admission blood glucose levels (BGA): normoglycemia (BGA < 7.8 mmol/L) and hyperglycaemia (BGA ≥ 7.8 mmol/L). The outcome was all-cause in-hospital mortality, which was analysed using logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
In total, 1239 patients were included (comprising 954 [77%] male patients; mean age, 53.0 years; and median BGA, 6.1 mmol/L). Logistic regression analysis showed that in-hospital mortality was 2.53 times greater for patients with hyperglycaemia versus the normoglycaemia group (95% CI 1.68, 3.80). This significant association persisted after adjustments for potential confounders (adjusted OR 2.45 [95% CI 1.58, 3.85]). Restricted cubic spline analysis revealed that the relationship between BGA and mortality reached statistical significance at BGA > 6.1 mmol/L. Stratified analysis and sensitivity analysis confirmed the robustness of this relationship.
Admission hyperglycaemia correlated with an elevated risk of in-hospital mortality in patients with hypertension and AAD, particularly BGA > 6.1 mmol/L, indicating that BGA level may be useful in identifying patients who are at an elevated risk of all-cause mortality.
入院高血糖被认为是心血管和脑血管疾病患者预后不良的一个因素。本研究旨在评估高血压合并急性主动脉夹层（AAD）患者入院高血糖与院内死亡率之间的关系。
本回顾性观察性研究纳入了 2010 年 1 月 1 日至 2023 年 3 月 1 日期间被诊断为高血压合并 AAD 的患者，并根据入院血糖水平（BGA）将其分为两组：正常血糖组（BGA＜7.8mmol/L）和高血糖组（BGA≥7.8mmol/L）。主要结局为全因院内死亡率，采用 logistic 回归计算比值比（ORs）及其 95%置信区间（CIs）。
共纳入 1239 例患者（包括 954 例[77%]男性患者；平均年龄为 53.0 岁；中位 BGA 为 6.1mmol/L）。logistic 回归分析显示，与正常血糖组相比，高血糖组的院内死亡率增加了 2.53 倍（95%CI 1.68，3.80）。在校正了潜在混杂因素后，这种显著关联仍然存在（调整后 OR 2.45[95%CI 1.58，3.85]）。限制性三次样条分析显示，BGA 与死亡率之间的关系在 BGA＞6.1mmol/L 时达到统计学显著水平。分层分析和敏感性分析证实了这种关系的稳健性。
高血压合并 AAD 患者入院高血糖与院内死亡率升高相关，尤其是 BGA＞6.1mmol/L 时，表明 BGA 水平可能有助于识别全因死亡率升高的患者。
