Glucose levels at hospital admission are associated with 5 year mortality

N. Wah Cheung; Patrick McElduff; Greg Fulcher; Sandy Middleton; Roger Chen; Barbara Depczynski; Jeff Flack; Jen Kinsella; Margaret Layton; Mark McLean; Ann Poynten; Katherine Tonks; Chris White; Vincent Wong; David R. Chipps

doi:10.1016/j.diabres.2024.111840

Glucose levels at hospital admission are associated with 5 year mortality

N. Wah Cheung, Patrick McElduff, Greg Fulcher, Sandy Middleton, Roger Chen, Barbara Depczynski, Jeff Flack, Jen Kinsella, Margaret Layton, Mark McLean, Ann Poynten, Katherine Tonks, Chris White, Vincent Wong, David R. Chipps

School of Medicine

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Aim: We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality.

Methods: A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed.

Results: There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes. Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors.

Conclusion: Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.

Original language	English
Article number	111840
Number of pages	7
Journal	Diabetes Research and Clinical Practice
Volume	217
DOIs	https://doi.org/10.1016/j.diabres.2024.111840
Publication status	Published - Nov 2024

Bibliographical note

Publisher Copyright:
© 2024 Elsevier B.V.

Keywords

Diabetes
Glucose
Hospital
Hyperglycaemia
Survival analysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cheung, N. W., McElduff, P., Fulcher, G., Middleton, S., Chen, R., Depczynski, B., Flack, J., Kinsella, J., Layton, M., McLean, M., Poynten, A., Tonks, K., White, C., Wong, V., & Chipps, D. R. (2024). Glucose levels at hospital admission are associated with 5 year mortality. Diabetes Research and Clinical Practice, 217, Article 111840. https://doi.org/10.1016/j.diabres.2024.111840

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title = "Glucose levels at hospital admission are associated with 5 year mortality",

abstract = "Aim: We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality. Methods: A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed. Results: There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes. Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors. Conclusion: Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.",

keywords = "Diabetes, Glucose, Hospital, Hyperglycaemia, Survival analysis",

author = "Cheung, {N. Wah} and Patrick McElduff and Greg Fulcher and Sandy Middleton and Roger Chen and Barbara Depczynski and Jeff Flack and Jen Kinsella and Margaret Layton and Mark McLean and Ann Poynten and Katherine Tonks and Chris White and Vincent Wong and Chipps, {David R.}",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier B.V.",

year = "2024",

month = nov,

doi = "10.1016/j.diabres.2024.111840",

language = "English",

volume = "217",

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T1 - Glucose levels at hospital admission are associated with 5 year mortality

AU - Cheung, N. Wah

AU - McElduff, Patrick

AU - Fulcher, Greg

AU - Middleton, Sandy

AU - Chen, Roger

AU - Depczynski, Barbara

AU - Flack, Jeff

AU - Kinsella, Jen

AU - Layton, Margaret

AU - McLean, Mark

AU - Poynten, Ann

AU - Tonks, Katherine

AU - White, Chris

AU - Wong, Vincent

AU - Chipps, David R.

PY - 2024/11

Y1 - 2024/11

N2 - Aim: We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality. Methods: A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed. Results: There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes. Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors. Conclusion: Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.

AB - Aim: We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality. Methods: A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed. Results: There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes. Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors. Conclusion: Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.

KW - Diabetes

KW - Glucose

KW - Hospital

KW - Hyperglycaemia

KW - Survival analysis

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U2 - 10.1016/j.diabres.2024.111840

DO - 10.1016/j.diabres.2024.111840

M3 - Article

C2 - 39216794

AN - SCOPUS:85203280192

SN - 0168-8227

VL - 217

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 111840

ER -

Glucose levels at hospital admission are associated with 5 year mortality

Abstract

Bibliographical note

Keywords

UN SDGs

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