title: Association between blood glucose level and outcomes in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Increased blood glucose is associated with adverse clinical outcomes among patients with major illnesses. This study examined the association between blood glucose and adverse outcomes among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease, for which limited prior data were available.
  
  
  METHODS
  We studied a cohort of 209 hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease. Univariate analyses and multivariate logistic regression analyses with backward elimination method were performed to evaluate factors associated with in-hospital complications, length of hospitalization, 30-day hospital readmission, and 90-day all-cause mortality.
  
  
  RESULTS
  Multivariate logistic regression analysis with backward elimination method revealed that lower blood glucose and age at hospital admission were the most significant risk factors for in-hospital complication. Received respiratory support and in-hospital complications were the most significant risk factors for the length of hospitalization. There were no significant risk factors associated with 30-day hospital readmission and 90-day all-cause mortality.
  
  
  CONCLUSIONS
  The analyses failed to reveal significant associations between higher blood glucose levels and adverse outcomes. We showed that lower glucose levels (hypoglycemia) results in higher risk for in-hospital complications. In-hospital complications results in longer length of hospitalization, which implies that lower glucose levels (hypoglycemia) indirectly may result in longer length of hospitalization. More studies are needed to better clarify the cause for these associations.
authors: Department of Internal Medicine, Marshfield Clinic Park Falls Center, Park Falls, Wis 54552, USA. kasirye.yusuf@marshfieldclinic.org
authors: Yusuf
authors: Y
authors: Kasirye
authors: Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, Wis, USA.
authors: Melissa
authors: M
authors: Simpson
authors: Department of Internal Medicine, Southern Illinois University, School of Medicine, Carbondale, Ill, USA.
authors: Chaitanya Kumar
authors: CK
authors: Mamillapalli
authors: Department of Biostatistics and Bioinformatics, Marshfield Clinic, Marshfield, Wis, USA.
authors: Narendranath
authors: N
authors: Epperla
authors: Department of Biostatistics and Bioinformatics, Marshfield Clinic, Marshfield, Wis, USA.
authors: Hong
authors: H
authors: Liang
authors: Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, Wis, USA.
authors: Steven H
authors: SH
authors: Yale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000401:mortality; D012307:Risk Factors; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D001786:Blood Glucose