scholarly journals Elevation of blood glucose level predicts worse outcomes in hospitalized patients with COVID-19: a retrospective cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e001476 ◽  
Author(s):  
Jianfeng Wu ◽  
Jianqiang Huang ◽  
Guochao Zhu ◽  
Qiongya Wang ◽  
Qingquan Lv ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Risk Factor ◽  
Blood Glucose ◽  
Hospital Mortality ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Hospitalized Patients ◽  
Medical Resources

IntroductionWith intense deficiency of medical resources during COVID-19 pandemic, risk stratification is of strategic importance. Blood glucose level is an important risk factor for the prognosis of infection and critically ill patients. We aimed to investigate the prognostic value of blood glucose level in patients with COVID-19.Research design and methodsWe collected clinical and survival information of 2041 consecutive hospitalized patients with COVID-19 from two medical centers in Wuhan. Patients without available blood glucose level were excluded. We performed multivariable Cox regression to calculate HRs of blood glucose-associated indexes for the risk of progression to critical cases/mortality among non-critical cases, as well as in-hospital mortality in critical cases. Sensitivity analysis were conducted in patient without diabetes.ResultsElevation of admission blood glucose level was an independent risk factor for progression to critical cases/death among non-critical cases (HR=1.30, 95% CI 1.03 to 1.63, p=0.026). Elevation of initial blood glucose level of critical diagnosis was an independent risk factor for in-hospital mortality in critical cases (HR=1.84, 95% CI 1.14 to 2.98, p=0.013). Higher median glucose level during hospital stay or after critical diagnosis (≥6.1 mmol/L) was independently associated with increased risks of progression to critical cases/death among non-critical cases, as well as in-hospital mortality in critical cases. Above results were consistent in the sensitivity analysis in patients without diabetes.ConclusionsElevation of blood glucose level predicted worse outcomes in hospitalized patients with COVID-19. Our findings may provide a simple and practical way to risk stratify COVID-19 inpatients for hierarchical management, particularly where medical resources are in severe shortage during the pandemic.

scholarly journals Risk of Stroke-Associated Pneumonia During Hospitalization: Predictive Ability of Combined A2DS2 Score and Hyperglycemia

2019 ◽  
Author(s):  
Yang Li ◽  
Yu Zhang ◽  
Sheng Lian Ma ◽  
Xiaoyuan Niu ◽  
Junsen Chang
Keyword(s):  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Independent Risk Factor ◽  
Fasting Blood Glucose ◽  
Predictive Ability ◽  
Roc Curve Analysis ◽  
Specificity And Sensitivity ◽  
Independent Risk Factors

Abstract Background: Stroke-associated pneumonia (SAP) is a common complication of cerebrovascular disease. The A 2 DS 2 score has been used to predict the risk of SAP. However, hyperglycemia is not included in this scale. The purpose of the present study was to explore whether the A 2 DS 2 scoring system and hyperglycemia could predict the risk of SAP more effectively than the conventional A 2 DS 2 scale. Methods: This retrospective study enrolled 2,552 patients with acute ischemic stroke. The A 2 DS 2 scores, fasting blood glucose level and blood glucose level on admission were collected. Regression analysis was used to identify the independent risk factors of SAP. ROC curve analysis was used to evaluate the specificity and sensitivity of the combined A 2 DS 2 score and fasting hyperglycemia for predicting SAP. Results: Fasting hyperglycemia was an independent risk factor for SAP (OR=2.95; 95% confidence interval: 2.11-4.12; P< 0.001). The area under curve of the combined A 2 DS 2 score and fasting hyperglycemia was significantly higher than that of the A 2 DS 2 score alone (0.814 vs. 0.793; P =0.020). Conclusion: Fasting hyperglycemia is an independent risk factor for predicting SAP. Compared with the A2DS2 score, the modified A2DS2 score (combined A2DS2 score and fasting hyperglycemia) is more effective in predicting the risk of SAP. Keywords : Stroke-associated pneumonia; A 2 DS 2 score; Fasting hyperglycemia; Predictive value

scholarly journals Risk of Stroke-Associated Pneumonia During Hospitalization: Predictive Value of Combined A2DS2 Score and Hyperglycemia

2019 ◽  
Author(s):  
Yang Li ◽  
Yu Zhang ◽  
Sheng Lian Ma ◽  
Xiaoyuan Niu ◽  
Junsen Chang
Keyword(s):  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Predictive Value ◽  
Independent Risk Factor ◽  
Fasting Blood Glucose ◽  
Roc Curve Analysis ◽  
Specificity And Sensitivity ◽  
Independent Risk Factors

Abstract Background: Stroke-associated pneumonia (SAP) is a common complication of cerebrovascular disease. The A2DS2 score has been used to predict the risk of SAP. However, hyperglycemia is not included in this scale. The purpose of the present study was to determine whether combining the A2DS2 scoring system and hyperglycemia can improve the predictive value of the conventional A2DS2 scale for SAP. Methods: This retrospective study enrolled 2,552 patients with acute ischemic stroke. The A2DS2 scores, fasting blood glucose level and blood glucose level on admission were collected. Regression analysis was used to identify the independent risk factors of SAP. ROC curve analysis was used to evaluate the specificity and sensitivity of the combined A2DS2 score and fasting hyperglycemia for predicting SAP. Results: Fasting hyperglycemia was an independent risk factor for SAP (OR=2.95; 95% confidence interval: 2.11-4.12; P<0.001). The area under curve of the combined A2DS2 score and fasting hyperglycemia was significantly higher than that of the A2DS2 score alone (0.814 vs. 0.793; P=0.048). Conclusion: Fasting hyperglycemia is an independent risk factor for predicting SAP. The predictive value of the modified A2DS2 score (combined A2DS2 score and fasting hyperglycemia) is superior to that of A2DS2 score. Keywords: Stroke-associated pneumonia; A2DS2 score; Fasting hyperglycemia; Predictive value

scholarly journals Risk of stroke-associated pneumonia during hospitalization: predictive ability of combined A2DS2 score and hyperglycemia

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yang Li ◽  
Yu Zhang ◽  
Liansheng Ma ◽  
Xiaoyuan Niu ◽  
Junsen Chang
Keyword(s):  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Independent Risk Factor ◽  
Fasting Blood Glucose ◽  
Predictive Ability ◽  
Roc Curve Analysis ◽  
Specificity And Sensitivity ◽  
Independent Risk Factors

Abstract Background Stroke-associated pneumonia (SAP) is a common complication of cerebrovascular disease. The A2DS2 score has been used to predict the risk of SAP. However, hyperglycemia is not included in this scale. The purpose of the present study was to explore whether the A2DS2 scoring system and hyperglycemia could predict the risk of SAP more effectively than the conventional A2DS2 scale. Methods This retrospective study enrolled 2552 patients with acute ischemic stroke. The A2DS2 scores, fasting blood glucose level and blood glucose level on admission were collected. Regression analysis was used to identify the independent risk factors of SAP. ROC curve analysis was used to evaluate the specificity and sensitivity of the combined A2DS2 score and fasting hyperglycemia for predicting SAP. Results Fasting hyperglycemia was an independent risk factor for SAP (OR = 2.95; 95% confidence interval: 2.11–4.12; P < 0.001). The area under curve of the combined A2DS2 score and fasting hyperglycemia was significantly higher than that of the A2DS2 score alone (0.814 vs. 0.793; P = 0.020). Conclusion Fasting hyperglycemia is an independent risk factor for predicting SAP. Compared with the A2DS2 score, the modified A2DS2 score (combined A2DS2 score and fasting hyperglycemia) is more effective in predicting the risk of SAP.

scholarly journals Risk of Stroke-Associated Pneumonia During Hospitalization: Predictive Value of Combined A2DS2 Score and Hyperglycemia

2019 ◽  
Author(s):  
Yang Li ◽  
Yu Zhang ◽  
Sheng Lian Ma ◽  
Xiaoyuan Niu ◽  
Junsen Chang
Keyword(s):  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Predictive Value ◽  
Independent Risk Factor ◽  
Fasting Blood Glucose ◽  
Roc Curve Analysis ◽  
Specificity And Sensitivity ◽  
Independent Risk Factors

Abstract Background: Stroke-associated pneumonia (SAP) is a common complication of cerebrovascular disease. The A2DS2 score has been used to predict the risk of SAP. However, hyperglycemia is not included in this scale. The purpose of the present study was to determine whether combining the A2DS2 scoring system and hyperglycemia can improve the predictive value of the conventional A2DS2 scale for SAP. Methods: This retrospective study enrolled 2,552 patients with acute ischemic stroke. The A2DS2 scores, fasting blood glucose level and blood glucose level on admission were collected. Regression analysis was used to identify the independent risk factors of SAP. ROC curve analysis was used to evaluate the specificity and sensitivity of the combined A2DS2 score and fasting hyperglycemia for predicting SAP. Results: Fasting hyperglycemia was an independent risk factor for SAP (OR=2.95; 95% confidence interval: 2.11-4.12; P<0.001). The area under curve of the combined A2DS2 score and fasting hyperglycemia was significantly higher than that of the A2DS2 score alone (0.814 vs. 0.793; P=0.020). Conclusion: Fasting hyperglycemia is an independent risk factor for predicting SAP. The predictive value of the modified A2DS2 score (combined A2DS2 score and fasting hyperglycemia) is superior to that of A2DS2 score.

scholarly journals Prevalence of missed hyperglycaemia among Jordan University Hospital mortality discharges, 1995-97

2001 ◽  
Vol 7 (1-2) ◽  
pp. 46-51 ◽  
Author(s):  
E. Younis ◽  
A. Badheeb ◽  
H. Ajlouni ◽  
S. A. Kareem ◽  
K. Ajlouni
Keyword(s):  
Blood Glucose ◽  
Hospital Mortality ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Health Professionals ◽  
Fasting Blood Glucose ◽  
University Hospital ◽  
Laboratory Results ◽  
Hospital Deaths ◽  
Diagnosed Diabetes

Tostudy the prevalence of recognized and unrecognized hyperglycaemia [defined as fasting blood glucose >/= 140 mg/dL and/or random blood glucose >/= 200 mg/dL on two or more occasions], data were collected from Jordan University Hospital on all hospital deaths in those >/= 20 years of age, for the years 1995-97. The prevalence of diagnosed diabetes was 35.3% and 19.2% were missed cases of hyperglycaemia; of the missed cases, 65.7% had a blood glucose level > 250 mg/dL. Thus, the prevalence of missed hyperglycaemia among hospitalized patients is high, and greater vigilance needs to be exercised by physicians and other health professionals in reviewing laboratory results, especially those related to diabetes.

scholarly journals Admission blood glucose level as an ischemic stroke risk modifier in patients with new-onset non-valvular atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Bergamaschi ◽  
F Donati ◽  
P Paolisso ◽  
L Bartoli ◽  
F Angeli ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Stroke Risk ◽  
Cox Regression ◽  
Independent Predictor ◽  
Risk Modifier ◽  
New Onset

Abstract Background Several scores have been proposed to assess the stroke risk in patients with non-valvular atrial fibrillation (NVAF). However, type 2 diabetes mellitus (T2DM) is considered a major stroke risk factor regardless of glycemic control. Whether basal blood glucose level modifies the risk of stroke in NVAF is still unclear. Purpose To evaluate the risk of ischemic stroke according to the presence of T2DM and admission blood glucose (ABG) level in patients with new-onset NVAF starting direct oral anticoagulants (DOACs). Methods We analyzed all consecutive patients with NVAF at our outpatient clinic from January to December 2018. The study population was constituted by 1014 patients with new-onset NVAF starting DOACs. Baseline characteristics were evaluated in the overall cohort whereas outcomes were assessed for 915 patients. The median follow-up time was 19.6±12.9 months. Results Overall, 50.3% were male with a mean age of 73.9±12.5 years. Diabetic NVAF patients were more frequently male (p=0.04) with higher prevalence of dyslipidemia (p&lt;0.001), hypertension (p&lt;0.001), severe renal impairment (p=0.02), peripheral vasculopathy (p=0.007) and history of myocardial infarction (p&lt;0.001) compared to non-diabetic NVAF. Conversely, no differences were observed between subgroups in terms of age (p=0.8). Baseline blood glucose level was significantly higher in the diabetic NVAF population (160±67 mg/dL vs 119±39 mg/dL; p&lt;0.001). As expected, the mean CHA2DS2-VASc score was significantly higher in diabetic NVAF compared to non-diabetic group (4.7±1.4 vs 3.2±1.5; p&lt;0.001). During a 2 year-follow up period, we collected 27 (3.0%) ischemic stroke. As expected, the rates of stroke were significantly higher in diabetic NVAF (7.6% vs 2.3%, p&lt;0.001). Also, the ABG was significantly greater in NVAF who had an ischemic stroke compared to others (160±68 mg/dL vs 119±39 mg/dL, p=0.005). The incidence of stroke was almost five-time greater in NVAF with ABG level major than 150 mg/dl (9.8% vs 1.9%, p&lt;0.001). At multivariate Cox-regression model adjusted for age, sex and presence of T2DM, blood glucose level at admission was the only independent predictor of ischemic stroke at follow up (HR 1.01, 95% CI 1.001–1.02; p=0.03). Finally, another multivariate Cox-regression model, adjusted for the mean CHA2DS2-VASc score, showed that the ABG level still remained a strong independent predictor of ischemic stroke at follow up (HR 1.012, 95% CI 1.003–1.02; p=0.01). Conclusions Diabetic NVAF had a worse baseline profile and higher stroke risk compared to non-diabetic NVAF. Baseline blood glucose level was an independent predictor of stroke regardless of the presence of T2DM or stroke risk profile. These findings underline the role of basal blood glucose level as a potential stroke risk modifier and therefore emphasize the importance of its routine determination to better stratify the stroke risk in NVAF starting DOACs. Funding Acknowledgement Type of funding source: None

scholarly journals The Experiance of Diabetisi in Controlling Blood Glucose Level in the Distric Health Centers Limboto Gorontalo Work

2018 ◽  
Author(s):  
Harismayanti
Keyword(s):  
Qualitative Research ◽  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Phenomenological Approach ◽  
Health Centers ◽  
Glucose Levels ◽  
Blood Glucose Levels

The purpose of this research was to find Knowledge able people with diabetes experiance incontrolling blood glucose levels in the region of Puskesmas Limboto Gorontalo District.Thedesign of qualitative research with phenomenological approach using purposive samplingtechnique with a number of 7 participants. The result identified five themes, namely change inthe perceived participantsafter diagnosis of DM, DM risk factor, enabling factor incontrolling blood glucose levels and obstacles in controlling blood glucose levels.

Abstract 19772: The Significance of Blood Pressure on Cardiovascular Risk Attributable to Diabetes

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryosuke Komi ◽  
Fumitaka Tanaka ◽  
Shinji Makita ◽  
Toshiyuki Onoda ◽  
Kozo Tanno ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Cox Regression ◽  
Fasting Blood Glucose ◽  
Antihypertensive Agents ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cox Regression Analysis

Background: Diabetes mellitus (DM) is an established risk factor of atherosclerotic cardiovascular events (CVE). Individuals with DM often have elevated levels of blood pressure (BP) which is closely associated with CVE. Hypothesis: The risk of DM-related CVE may depend on BP levels. Methods: A population-based prospective cohort study was performed in 24,350 subjects aged 40 to 89 years (mean age = 63.0±10.0 years) who did not have a history of CVE. DM was defined as a casual blood glucose level ≥ 200 mg/dl or fasting blood glucose level ≥ 126 mg/dl, a glycated hemoglobin value ≥ 6.5%, and/or current anti-diabetic therapy. BP levels at the baseline examination were classified into three categories including normotension, pre-hypertension, and hypertension according to JNC7. This classification was applied also to subjects with antihypertensive agents use. After adjustment for age, sex, body mass index, eGFR, total and HDL cholesterol, smoking habits, and anti-hypertensive medication use, a multivariate Cox regression analysis was performed to examine an association and contribution of pre-hypertension and hypertension on the risk of CVE in DM and non DM. Results: During a mean follow-up period of 5.5 years, 746 subjects developed CVE which was defined as stroke or acute myocardial infarction/sudden cardiac death. In both DM and non DM, the hazard ratios for CVE were increased in pre-hypertensives (HR 1.25, p < 0.05; HR 2.59, p < 0.02, respectively) and in hypertensives (HR 1.82, p < 0.01; HR 3.66, p < 0.01, respectively) in comparison with normotensives. However, the population-attributable fractions (PAFs) of pre-hypertension and hypertension were apparently higher in DM (21.5%, 41.2%, respectively), as these were more than double compared to PAFs in non DM (6.7%, 20.3%, respectively). Conclusions: Approximately two-third of excess CVE attributable to DM is estimated to occur among individuals with elevated BP levels.

scholarly journals Phenomenological Study : The Experiance of Diabetisi in Controlling Blood Glucose Level in the Distric Health Centers Limboto Gorontalo Work

2018 ◽  
Author(s):  
Harismayanti
Keyword(s):  
Qualitative Research ◽  
Risk Factor ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Phenomenological Study ◽  
Phenomenological Approach ◽  
Health Centers ◽  
Glucose Levels ◽  
Blood Glucose Levels

The purpose of this research was to find Knowledge able people with diabetes experiance incontrolling blood glucose levels in the region of Puskesmas Limboto Gorontalo District.Thedesign of qualitative research with phenomenological approach using purposive samplingtechnique with a number of 7 participants. The result identified five themes, namely change inthe perceived participantsafter diagnosis of DM, DM risk factor, enabling factor incontrolling blood glucose levels and obstacles in controlling blood glucose levels.

Sign in / Sign up

Export Citation Format

Share Document