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Admission Blood Glucose Level and Mortality Among Hospitalized Nondiabetic Patients With Heart Failure
Alon Barsheshet, MD;
Moshe Garty, MD, MSc;
Ehud Grossman, MD;
Amir Sandach, MSc;
Basil S. Lewis, MD;
Shmuel Gottlieb, MD;
Abraham Shotan, MD;
Solomon Behar, MD;
Avi Caspi, MD;
Roseline Schwartz, MSc;
Alexander Tenenbaum, MD;
Jonathan Leor, MD
Arch Intern Med. 2006;166:1613-1619.
Background The significance of admission blood glucose level in nondiabetic patients with heart failure (HF) is unknown. We examined the possible association between admission glucose levels and outcome in a large cohort of hospitalized patients with HF.
Methods We analyzed the data of 4102 patients with HF, who were hospitalized during a prospective national survey. The present study focuses on a subgroup of 1122 nondiabetic patients with acute HF who were admitted because of acute HF or exacerbation of chronic HF.
Results In-hospital mortality was twice as high in patients with admission blood glucose levels in the third tertile (7.2%) compared with the first (3%) and second (4%) tertiles (P = .02). Furthermore, mortality risk was correlated with admission glucose levels; each 18-mg/dL (1-mmol/L) increase in glucose level was associated with a 31% increased risk of in-hospital mortality (adjusted odds ratio, 1.31; 95% confidence interval, 1.10-1.57; P = .003) and a 12% increase in 60-day mortality (adjusted hazard ratio, 1.12; 95% confidence interval, 1.01-1.25; P = .04). Admission blood glucose levels remained an independent predictor of in-hospital and 60-day mortality even after the exclusion of 315 patients (28%) with acute myocardial infarction and HF. The 6- and 12-month mortality rates were similar in patients with and without abnormal admission blood glucose levels.
Conclusions Elevated admission blood glucose levels are associated with increased in-hospital and 60-day mortality, but not 6-month or 1-year mortality, in nondiabetic patients hospitalized because of HF.
Author Affiliations: Neufeld Cardiac Research Institute (Drs Barsheshet, Gottlieb, Shotan, Behar, Caspi, Tenenbaum, and Leor and Mss Sandach and Schwartz) and Department of Internal Medicine D (Dr Grossman), Sheba Medical Center, Tel Hashomer, Israel; Recanati Center for Internal Medicine and Research, Rabin Medical Center, Petah Tiqva, Israel (Dr Garty); and Lady Davis Carmel Medical Center and Ruth and Bruce Rappaport School of Medicine, Haifa, Israel (Dr Lewis).
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ABSTRACT
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High Blood Glucose Raises Mortality for Inpatients With Heart Failure
DOC News 2006;3:12-12.
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