Endocrine Abstracts

Context: Hyperglycemia is common among patients with and without diabetes mellitus (DM) hospitalized for infectious diseases. The long-term outcomes of hyperglycemia have not been adequately studied in this population.

Objective: Examine the prognostic implications of hyperglycemia and the importance of glycemic control in patients with and without DM during hospitalization for infectious diseases.

Methods: Historical prospectively collected data of patients hospitalized between 2011 and 2013. Infection-related hospitalizations were classified according to site of infection. Median follow-up was 4.5 years. Outcome measures included in-hospital and end-of-follow-up mortality.

Setting: Historical prospectively collected data of patients hospitalized between January 2011 and December 2013.

Patients: Patients ≥18 years.

Main outcome: Length of stay, in-hospital and end-of-follow-up mortality.

Results: The cohort included 8051 patients (50% female, mean age ± S.D., 68±20 years) with a primary diagnosis of an infectious disease. Of these, 2363 patients (29%) had type 2 DM. The most common infectious sites included respiratory tract (n=3285), genitourinary tract (n=1804), skin and soft tissue (n=934) and gastrointestinal tract (n=571). There was no difference in admission rates of patients with and without DM according to the site of infection, except for skin and soft tissue infection which were more common among patients with DM (16% vs. 10%). In-hospital mortality risk was greater in patients with DM (aOR=1.3, 95% CI =1.1–1.7). In the entire cohort, adjusted mortality risk (aHR, 95% CI) at the end-of-follow-up was greater among patients with DM (1.2, 1.1–1.4), with increased mortality risk following hospitalization for respiratory (1.1, 1.0–1.4) and skin and soft tissue infections (1.7, 1.3–2.3). In-hospital and end-of-follow-up mortality risk were highest among patients with and without DM with median glucose >180 mg/dl during hospitalization.

Conclusions: In patients hospitalized for infectious diseases, DM is associated with increased long-term mortality risk, specifically following hospitalization for respiratory and skin and soft tissue infections. Poor glycemic control in patients with and without DM during hospitalization is associated with increased long-term mortality.