Endocrine Abstracts

Background: Glucose variability (GV) is common among hospitalized patients but the prognostic implications among patients hospitalized to surgical wards are unknown.

Objective: Investigate the association between GV, length of stay (LOS) and mortality.

Methods: Historical prospectively collected data of patients ≥18 years, hospitalized to general surgery wards between January 2011–December 2017. GV was assessed by coefficient of variance (CV) and standard deviation (SD) of glucose values during hospitalization. The main outcomes were LOS, 30-day and end-of-follow-up mortality.

Results: Cohort included 8,894 patients (mean age 63±19 years, 48% male, mean follow-up 3.0±1.8 years); 2,012 (23%) patients with diabetes mellitus (DM). Mean LOS was longer with higher CV or SD in patients without and with DM. 30-day mortality was 6%, associated with higher vs. lower CV (9% vs. 3%) and SD (9% vs. 3%) in patients without DM and with DM (9% vs. 5%; 8% vs. 5%, respectively). Mortality at the end-of-follow-up was increased in patients without DM with higher CV (27% vs. 18%) and SD (29% vs. 17%) and in patients with DM (33% vs. 24% and 32% vs. 21%, respectively). Multivariate analysis indicated increased risk for 30-day and end-of-follow-up mortality, in both groups. Adjustment for glucocorticoid treatment or hypoglycemia did not affect the results. In patients with high or low CV, mortality was higher with median glucose levels during hospitalization ≥180 mg/dl, compared with <180 mg/dl.

Conclusions: In patients with and without DM hospitalized to general surgery wards, increased GV is associated with longer hospitalization and increased short- and long-term mortality.