COVID-19感染患者院前血糖水平与预后之间的关系:一项回顾性队列研究

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Experimental and Clinical Endocrinology & Diabetes Pub Date : 2023-06-01 DOI:10.1055/a-2068-6821

Christophe A Fehlmann, Laurent Suppan, Christophe Gaudet-Blavignac, Nadia Elia, Karim Gariani

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引用次数: 1

摘要

背景:在许多情况下，高血糖与较差的预后相关。然而，在COVID-19患者中，血糖异常与不良结局之间的关系仍存在争议。本研究确定了院前血糖水平与covid -19感染患者急性医疗单位(重症监护病房或高依赖病房)入院和死亡率的关系。方法:这是一项单中心、回顾性队列研究，基于2020年3月至2021年4月期间瑞士大学医院院前医疗流动单元护理的患者。所有在研究期间确诊或疑似COVID-19感染的成年患者均被纳入研究。数据来自院前医疗档案。主要暴露于院前血糖水平。采用7.8 mmol/L临界值定义高血糖水平。限制三次样条也被用来分析暴露作为一个连续变量。主要终点是急诊住院;次要终点为7天和30天死亡率。采用多变量logistic回归计算比值比。结果:共纳入276例患者。院前平均血糖8.8 mmol/l, 123例患者出现高血糖。总体急诊住院率为31.2%，院前血糖水平差异无统计学意义。7 d死亡率为13.8%，30 d死亡率为25%。院前血糖水平高的患者30天死亡率更高，校正优势比为2.5(1.3-4.8)。结论:在急性COVID-19感染患者中，院前血糖水平似乎与急性医疗单位入院无关。然而，院前血糖水平高的COVID-19患者30天死亡的风险增加。

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Association Between Prehospital Blood Glucose Levels and Outcomes in Patients With COVID-19 Infection: A Retrospective Cohort Study.

Background: Hyperglycaemia is associated with worse outcomes in many settings. However, the association between dysglycaemia and adverse outcomes remains debated in COVID-19 patients. This study determined the association of prehospital blood glucose levels with acute medical unit (intensive care unit or high dependency unit) admission and mortality among COVID-19-infected patients.

Methods: This was a single-centre, retrospective cohort study based on patients cared for by the prehospital medical mobile unit from a Swiss university hospital between March 2020 and April 2021. All adult patients with confirmed or suspected COVID-19 infection during the study period were included. Data were obtained from the prehospital medical files. The main exposure was prehospital blood glucose level. A 7.8 mmol/L cut-off was used to define high blood glucose level. Restricted cubic splines were also used to analyse the exposure as a continuous variable. The primary endpoint was acute medical unit admission; secondary endpoints were 7-day and 30-day mortality. Multivariable logistic regressions were performed to compute odds ratios.

Results: A total of 276 patients were included. The mean prehospital blood glucose level was 8.8 mmol/l, and 123 patients presented high blood glucose levels. The overall acute medical unit admission rate was 31.2%, with no statistically significant difference according to prehospital blood glucose levels. The mortality rate was 13.8% at 7 days and 25% at 30 days. The 30-day mortality rate was higher in patients with high prehospital blood glucose levels, with an adjusted odds ratio of 2.5 (1.3-4.8).

Conclusions: In patients with acute COVID-19 infection, prehospital blood glucose levels do not seem to be associated with acute medical unit admission. However, there was an increased risk of 30-day mortality in COVID-19 patients who presented high prehospital blood glucose levels.

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来源期刊

Experimental and Clinical Endocrinology & Diabetes 医学-内分泌学与代谢

CiteScore

4.10

自引率

5.60%

发文量

审稿时长

3 months

期刊介绍： Publishing outstanding articles from all fields of endocrinology and diabetology, from molecular biology to clinical research, this journal is a brilliant resource. Since being published in English in 1983, the popularity of this journal has grown steadily, reflecting the importance of this publication within its field. Original contributions and short communications appear in each issue along with reviews addressing current topics. In addition, supplementary issues are published each year presenting abstracts or proceedings of national and international scientific meetings. The journal was initially published in German and is still the oldest endocrinological periodical in the German-language market!