title: The prognostic significance of admission blood glucose levels in elderly patients with pneumonia (GAP Study).
abstract: Evaluate the association between admission blood glucose (ABG) and short and long-term mortality following hospitalization for pneumonia of elderly patients with and without diabetes mellitus (DM).
  
  
  
  Observational data derived from the electronic records of hospitalized patients ≥65years, admitted for pneumonia between January 2011 and December 2013. ABG levels were classified to categories: ≤70 (low), 70-110 (normal), 111-140 (mildly elevated), 141-199mg/dl (moderately elevated) and ≥200mg/dl (markedly elevated). Main outcomes were all-cause mortality rates at various time points.
  
  
  
  Cohort included 2164 patients, 743 with DM (mean age 81, 53% male) and 1421 without it (mean age 83, 52% male). There was a significant interaction between DM, ABG and mortality (p≤0.05). In patients without DM, compared with normal ABG, in-hospital and 30-day mortality rates (adjusted hazard ratio, 95% CI) were higher with moderately (1.5 and 1.4, respectively, p<0.05) and markedly elevated ABG (2.7 and 1.9, respectively, p<0.05). Long-term results were similar at 12 and 36months (1.3 and 1.8, respectively, p<0.05, for moderately and markedly elevated ABG).
  
  
  
  In elderly non-diabetic patients hospitalized for pneumonia, moderately and markedly elevated ABG is associated with increased short- and long-term mortality. In diabetic patients there is no association between ABG and mortality.
authors.affiliation: Institute of Endocrinology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: amit.akirov@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Akirov
authors.affiliation: Institute of Endocrinology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D048909:Diabetes Complications / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007003:Hypoglycemia / Q000150:complications*; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose
keywords: Admission; Diabetes mellitus; Geriatrics; Glucose; Mortality; Pneumonia