Incidence and prognostic significance of hypoglycemia in hospitalized non-diabetic elderly patients.
OBJECTIVE
To assess the incidence and prognostic value of hypoglycemia in hospitalized non-diabetic elderly patients.


METHODS
An observational retrospective study, with a 3-year follow-up, was performed in a series of 678 patients aged over 65 years, admitted between January 1 2001 and December 31 2001 to the Units of Gerontology and Geriatrics of the Careggi University Hospital, Florence, Italy. Patients with diabetes mellitus were excluded. To determine the cumulative incidence of hypoglycemia, all measurements of venous or capillary blood glucose during hospital stay were taken into account. In-hospital mortality was determined from hospital discharge records. Information on all-cause, three-year mortality after hospital admission was obtained from the City of Florence Registry Office.


RESULTS
Hypoglycemia was observed in 8.6% of patients, and was asymptomatic in about 25% of cases. In-hospital mortality was significantly higher in patients with hypoglycemia (41.4% vs 14.3%; p<0.001), even after adjustment for potential confounders, including comorbidity, indices of malnutrition, and pharmacological treatment (adjusted OR 2.17[1.25;3.85]). 3-year mortality was significantly higher in patients with hypoglycemia during hospital stay, but the difference was not significant after adjustment for confounders.


CONCLUSIONS
Hypoglycemia is a prognostic marker of in-hospital mortality in non-diabetic hospitalized patients, even after adjustment for comorbidity and indices of malnutrition. Instead, it does not seem to have any relevant independent prognostic value in the longer term.
Mannucci
Edoardo
E
Department of Critical Care and Surgery, Unit of Gerontology and Geriatrics, University of Florence, and Azienda Ospedaliero-Universitaria Careggi, Via delle Oblate 4, 50141 Florence, Italy. edmannu@tin.it
Monami
Matteo
M
Mannucci
Marco
M
Chiasserini
Veronica
V
Nicoletti
Paola
P
Gabbani
Luciano
L
Giglioli
Leonetto
L
Masotti
Giulio
G
Marchionni
Niccolò
N
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology*; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D008297:Male; D044342:Malnutrition; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors