Mortality in hospitalized patients with hypoglycemia and severe hyperglycemia.
BACKGROUND
We designed a study to determine the incidence, cause, and implications of hypoglycemia (< or = 2.7 mmol/L, 49 mg/dL) and severe hyperglycemia (> or = 22.2 mmol/L, 400 mg/dL) in in-patients at an urban tertiary medical center.


METHODS
A daily computer search of the Laboratory Information System identified all hospitalized patients with hypoglycemia and severe hyperglycemia during a 49-day period. Chart review was used to assess demographic information, risk factors, and epidemiologic variables. The eventual outcome of the hospitalization was obtained by follow-up.


RESULTS
The incidence of hypoglycemia was 1.5%, and of hyperglycemia, 1.9%. Seventy-six percent of the hypoglycemic patients and 16% of the hyperglycemic patients had no prior history of diabetes. The mortality rate for hypoglycemic patients was 22.2%; for hyperglycemic patients it was 11.1%. For all other hospitalized patients it was 2.3% (p < 0.0001). Mortality rates for the black and Hispanic patients who were hypoglycemic (30% and 46%) were significantly higher than for white patients (6%, p < 0.01).


CONCLUSIONS
Hypoglycemia and severe hyperglycemia are not uncommon in hospitalized patients and serve as metabolic markers for patients at increased risk for inhospital mortality. Early identification of at-risk patients and the impact of aggressive treatment of their underlying disease processes should be evaluated in future studies.
Stagnaro-Green
A
A
Department of Nursing (PLL, EC), Mount Sinai School of Medicine, New York, NY 10029, USA.
Barton
M K
MK
Linekin
P L
PL
Corkery
E
E
deBeer
K
K
Roman
S H
SH
D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers; D016009:Chi-Square Distribution; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000401:mortality*; D007003:Hypoglycemia / Q000453:epidemiology / Q000401:mortality*; D015994:Incidence; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011446:Prospective Studies
D015415:Biomarkers