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Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
Print version ISSN 2225-5109On-line version ISSN 2227-4731
Abstract
GARCIA-RUIZ, Víctor Raúl et al. Admission glycemia associated with mortality and hospital stay in a multidisciplinary service of a Peruvian national hospital. Rev. Cuerpo Med. HNAAA [online]. 2022, vol.15, n.4, e1555. Epub Jan 28, 2023. ISSN 2225-5109. http://dx.doi.org/10.35434/rcmhnaaa.2022.154.1555.
Objective:
Evaluate the association between glycemia on admission and adverse outcomes in hospitalized patients with COVID19 in a Peruvian national hospital.
Methods:
Retrospective, observational cohort study. We collected data from electronic medical records of COVID19 patients in a medical specialties service. Patients were classified according to blood glucose levels on admission: ≤ and >140mg/dL. Primary outcome was mortality, and the secondary a composite that included mortality, septic shock, mechanical ventilation, or transfer to ICU. We also evaluated hospital stay and a multivariate logistic regression sub analysis was performed in diabetic patients.
Results:
169 patients were evaluated. The mean age was 61 years, 64.5% were male. 71% had at least one comorbidity, the most frequent: arterial hypertension (34%), obesity (30%) and diabetes (26%). 70% presented tomographic gravity. Median blood glucose at admission was 126.5mg/dL (IQR: 109-157mg/dL), one of every 3 had blood glucose levels >140mg/dL. Mortality rate was 9700 deaths per 100000 person-weeks, with a frequency of 21.3%. No significant difference was found between hyperglycemia and normoglycemia, mortality and in composite outcome. Patients with hyperglycemia on admission had longer hospital stay than normoglycemic patients (19 vs 13 days, p<0.01). In sub-analysis with multivariate logistic regression for composite outcome among diabetic patients, admission blood glucose >180mg/dL presented OR of 6.42 (95% CI: 1.07-38.6) for composite outcome, adjusted for age and clinical severity at admission.
Conclusions:
Hyperglycemia at admission was associated with a longer hospital stay and diabetic patients with hyperglycemia >180mg/dL had a 6-fold increased risk of presenting an adverse outcome.
Keywords : Blood Glucose; Diabetes Mellitus; COVID-19; SARS-CoV-2; Mortality; Mechanical Ventilation; Hospital Stay.