Association of In-Hospital Mortality and Dysglycemia in Septic Patients.

The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital m...

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Main Authors: Hsiao-Yun Chao, Peng-Hui Liu, Shen-Che Lin, Chun-Kuei Chen, Jih-Chang Chen, Yi-Lin Chan, Chin-Chieh Wu, Gerald N Blaney, Zhen-Ying Liu, Cho-Ju Wu, Kuan-Fu Chen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5249165?pdf=render
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spelling doaj-0929377b70cd4247ae614c500c9b605a2020-11-25T01:30:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01121e017040810.1371/journal.pone.0170408Association of In-Hospital Mortality and Dysglycemia in Septic Patients.Hsiao-Yun ChaoPeng-Hui LiuShen-Che LinChun-Kuei ChenJih-Chang ChenYi-Lin ChanChin-Chieh WuGerald N BlaneyZhen-Ying LiuCho-Ju WuKuan-Fu ChenThe associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital mortality of patients with suspected sepsis in emergency department (ED) and intensive care units.Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes. We analyzed patients' demographics, comorbidities, clinical and laboratory parameters, admission glucose levels and severity of sepsis. Odds ratio of mortality was assessed after adjusting for possible confounders. The correlations of admission glucose and CoV (blood glucose coefficients of variation) and mortality in diabetes and non-diabetes were also tested.Diabetes was present in 58.3% of the patients. Diabetic patients were older, more likely to have end-stage renal disease and undergoing hemodialysis, but had fewer malignancies, less sepsis severity (lower Mortality in Emergency Department Sepsis Score), less steroid usage in emergency department, and lower in-hospital mortality rate (aOR:0.83, 95% CI 0.65-0.99, p = 0.044). Hyperglycemia at admission (glucose≥200 mg/dL) was associated with higher risks of in-hospital mortality among the non-diabetes patients (OR:1.83 vs. diabetes, 95% CI 1.20-2.80, p = 0.005) with the same elevated glucose levels at admission. In addition, CoV>30% resulted in higher risk of death as well (aOR:1.88 vs. CoV between 10 and 30, 95%CI 1.24-2.86 p = 0.003).This study indicates that while diabetes mellitus seems to be a protective factor in sepsis patients, hyper- or hypoglycemia status on admission, and increased blood glucose variation during hospital stays, were independently associated with increased odds ratio of mortality.http://europepmc.org/articles/PMC5249165?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Hsiao-Yun Chao
Peng-Hui Liu
Shen-Che Lin
Chun-Kuei Chen
Jih-Chang Chen
Yi-Lin Chan
Chin-Chieh Wu
Gerald N Blaney
Zhen-Ying Liu
Cho-Ju Wu
Kuan-Fu Chen
spellingShingle Hsiao-Yun Chao
Peng-Hui Liu
Shen-Che Lin
Chun-Kuei Chen
Jih-Chang Chen
Yi-Lin Chan
Chin-Chieh Wu
Gerald N Blaney
Zhen-Ying Liu
Cho-Ju Wu
Kuan-Fu Chen
Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
PLoS ONE
author_facet Hsiao-Yun Chao
Peng-Hui Liu
Shen-Che Lin
Chun-Kuei Chen
Jih-Chang Chen
Yi-Lin Chan
Chin-Chieh Wu
Gerald N Blaney
Zhen-Ying Liu
Cho-Ju Wu
Kuan-Fu Chen
author_sort Hsiao-Yun Chao
title Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
title_short Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
title_full Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
title_fullStr Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
title_full_unstemmed Association of In-Hospital Mortality and Dysglycemia in Septic Patients.
title_sort association of in-hospital mortality and dysglycemia in septic patients.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2017-01-01
description The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital mortality of patients with suspected sepsis in emergency department (ED) and intensive care units.Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes. We analyzed patients' demographics, comorbidities, clinical and laboratory parameters, admission glucose levels and severity of sepsis. Odds ratio of mortality was assessed after adjusting for possible confounders. The correlations of admission glucose and CoV (blood glucose coefficients of variation) and mortality in diabetes and non-diabetes were also tested.Diabetes was present in 58.3% of the patients. Diabetic patients were older, more likely to have end-stage renal disease and undergoing hemodialysis, but had fewer malignancies, less sepsis severity (lower Mortality in Emergency Department Sepsis Score), less steroid usage in emergency department, and lower in-hospital mortality rate (aOR:0.83, 95% CI 0.65-0.99, p = 0.044). Hyperglycemia at admission (glucose≥200 mg/dL) was associated with higher risks of in-hospital mortality among the non-diabetes patients (OR:1.83 vs. diabetes, 95% CI 1.20-2.80, p = 0.005) with the same elevated glucose levels at admission. In addition, CoV>30% resulted in higher risk of death as well (aOR:1.88 vs. CoV between 10 and 30, 95%CI 1.24-2.86 p = 0.003).This study indicates that while diabetes mellitus seems to be a protective factor in sepsis patients, hyper- or hypoglycemia status on admission, and increased blood glucose variation during hospital stays, were independently associated with increased odds ratio of mortality.
url http://europepmc.org/articles/PMC5249165?pdf=render
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