Hypoglycemia is Associated with Increased In-Hospital Mortality in Patients with Liver Cirrhosis; A Nationwide Study

Adham E Obeidat, Ratib Mahfouz, Landon A Kozai, Mahmoud M. Mansour, M. Darweesh, Ahmad Alqam, Parthav Shah, Traci T Murakami
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Abstract

Hypoglycemia is Associated with Increased In-Hospital Mortality in Patients with Liver Cirrhosis; Nationwide Study. Abstract Aim: Cirrhosis may cause dysregulation of glucose homeostasis due to abnormalities in metabolism and responses to changes in the blood glucose level. Cirrhotic patients may be more prone to hypoglycemia. Hypoglycemia is associated with poor outcomes in cirrhotic patients with sepsis and may indicate a greater severity of illness. This study aims to elucidate the effect of hypoglycemia on in-hospital mortality in cirrhotic patients. were calcul-ated. Diabetic patients were excluded from the study to rule out the possibility of iatrogenic hypoglycemia. Results: Out of 1,778,829 inpatients with cirrhosis, 31,615 had a diagnosis of hypoglycemia. Total hospital charges were significantly higher in the cirrhosis and hypoglycemia group compared to the non-hypoglycemia group. The mean length of stay (LOS) in the hypoglycemia group was significantly higher. Mortality, vasopressor usage, mechanical ventilation, cardiac arrest, and intensive care unit (ICU) admission were significantly higher in the hypoglycemia group compared to the non-hypoglycemia one. Conclusion: In patients with cirrhosis, hypoglycemia was associated with higher in-hospital mortality and rate of critical illness as suggested by elevated rates of ICU admission, mechanical ventilation, and vasopre-ssor use. These patients also had longer hospital LOS and higher total hospital charges. Hypoglycemia may reflect advanced liver disease or indicate early sepsis and potentially forbodes a prolonged, complicated hospital course.
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低血糖与肝硬化患者住院死亡率升高相关一项全国性的研究
低血糖与肝硬化患者住院死亡率升高相关全国范围的研究。摘要目的:肝硬化可能由于代谢异常和对血糖水平变化的反应异常而导致葡萄糖稳态失调。肝硬化患者可能更容易发生低血糖。低血糖与肝硬化脓毒症患者预后不良相关,可能表明疾病的严重程度更高。本研究旨在探讨低血糖对肝硬化患者住院死亡率的影响。calcul-ated。糖尿病患者被排除在研究之外,以排除医源性低血糖的可能性。结果:在1778829例肝硬化住院患者中,31615例诊断为低血糖。肝硬化低血糖组的住院总费用明显高于非低血糖组。低血糖组的平均住院时间(LOS)明显高于对照组。与非低血糖组相比,低血糖组的死亡率、血管加压药的使用、机械通气、心脏骤停和重症监护病房(ICU)入院率显著高于非低血糖组。结论:在肝硬化患者中,低血糖与较高的住院死亡率和危重疾病发生率相关,这与ICU入院率、机械通气率和血管加压剂使用率升高有关。这些患者的住院时间也更长,住院总费用也更高。低血糖可能反映晚期肝病或早期败血症,并可能预示长期、复杂的住院过程。
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