Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged >= 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level >= 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia >= 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia >= 250 and < 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia >= 250 mg/dL (OR 2.07; [95% CI 1.34-3.19]), Barthel Index <= 40 (3.28[2.44-4.42]), CIRS-SI (1.87[1.27-2.77]), and male sex (1.54[1.16-2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level >= 250 mg/dL, Barthel Index <= 40, CIRS-SI, and male sex.
Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry / Corrao, Salvatore; Nobili, Alessandro; Natoli, Giuseppe; Mannucci, Pier Mannuccio; Perticone, Francesco; Pietrangelo, Antonello; Argano, Christiano; Null, Null; Mannucci, Pier Mannuccio; Nobili, Alessandro; Pietrangelo, Antonello; Perticone, Francesco; Licata, Giuseppe; Violi, Francesco; Corazza, Gino Roberto; Corrao, Salvatore; Marengoni, Alessandra; Salerno, Francesco; Cesari, Matteo; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Franchi, Carlotta; Cortesi, Laura; Tettamanti, Mauro; Miglio, Gabriella; Tettamanti, Mauro; Cortesi, Laura; Ardoino, Ilaria; Novella, Alessio; Prisco, Domenico; Silvestri, Elena; Emmi, Giacomo; Bettiol, Alessandra; Caterina, Cenci; Biolo, Gianni; Zanetti, Michela; Guadagni, Martina; Zaccari, Michele; Chiuch, Massimiliano; Zaccari, Michele; Vanoli, Massimo; Grignani, Giulia; Pulixi, Edoardo Alessandro; Bernardi, Mauro; Bassi, Silvia Li; Santi, Luca; Zaccherini, Giacomo; Lupattelli, Graziana; Mannarino, Elmo; Bianconi, Vanessa; Paciullo, Francesco; Alcidi, Riccardo; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Palazzuoli, Alberto; Girelli, Domenico; Busti, Fabiana; Marchi, Giacomo; Barbagallo, Mario; Dominguez, Ligia; Cocita, Floriana; Beneduce, Vincenza; Plances, Lidia; Natoli, Giuseppe; Mularo, Salvatore; Raspanti, Massimo; Argano, Christiano; Zoli, Marco; Lazzari, Ilaria; Brunori, Mattia; Fabbri, Elisa; Magalotti, Donatella; Arnò, Raffaella; Pasini, Franco Laghi; Capecchi, Pier Leopoldo; Palasciano, Giuseppe; Modeo, Maria Ester; Di Gennaro, Carla; Cappellini, Maria Domenica; Maira, Diletta; Di Stefano, Valeria; Fabio, Giovanna; Seghezzi, Sonia; Mancarella, Marta; De Amicis, Margherita Migone; De Luca, Giacomo; Scaramellini, Natalia; Cesari, Matteo; Rossi, Paolo Dionigi; Damanti, Sarah; Clerici, Marta; Conti, Federica; Bonini, Giulia; Ottolini, Barbara Brignolo; Di Sabatino, Antonio; Miceli, Emanuela; Lenti, Marco Vincenzo; Pisati, Martina; Dominioni, Costanza Caccia; Murialdo, Giovanni; Marra, Alessio; Cattaneo, Federico; Pontremoli, Roberto; Beccati, Valentina; Nobili, Giulia; Secchi, Maria Beatrice; Ghelfi, Davide; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Cipollone, Francesco; Guagnano, Maria Teresa; Valeriani, Emanuele; Rossi, Ilaria; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Delitala, Giuseppe; Berria, Maria; Pes, Chiara; Delitala, Alessandro; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Zuccalà, Giuseppe; D'Aurizio, Gabriella; Romanelli, Giuseppe; Marengoni, Alessandra; Zucchelli, Alberto; Manzoni, Francesca; Volpini, Andrea; Picardi, Antonio; Gentilucci, Umberto Vespasiani; Gallo, Paolo; Dell'Unto, Chiara; Annoni, Giorgio; Corsi, Maurizio; Bellelli, Giuseppe; Zazzetta, Sara; Mazzola, Paolo; Szabo, Hajnalka; Bonfanti, Alessandra; Arturi, Franco; Succurro, Elena; Rubino, Mariangela; Tassone, Bruno; Sesti, Giorgio; Serra, Maria Grazia; Bleve, Maria Antonietta; Gasbarrone, Laura; Sajeva, Maria Rosaria; Brucato, Antonio; Ghidoni, Silvia; Fabris, Fabrizio; Bertozzi, Irene; Bogoni, Giulia; Rabuini, Maria Victoria; Cosi, Elisabetta; Scarinzi, Paolo; Amabile, Annalisa; Omenetto, Elisabetta; Prandini, Tancredi; Manfredini, Roberto; Fabbian, Fabio; Boari, Benedetta; De Giorgi, Alfredo; Tiseo, Ruana; De Giorgio, Roberto; Paolisso, Giuseppe; Rizzo, Maria Rosaria; Borghi, Claudio; Strocchi, Enrico; Ianniello, Eugenia; Soldati, Mario; Sabbà, Carlo; Vella, Francesco Saverio; Suppressa, Patrizia; Schilardi, Andrea; Loparco, Francesca; De Vincenzo, Giovanni Michele; Comitangelo, Alessio; Amoruso, Emanuele; Fenoglio, Luigi; Falcetta, Andrea; Bracco, Christian; Fargion, Anna L. Fracanzani Silvia; Tiraboschi, Silvia; Cespiati, Annalisa; Oberti, Giovanna; Sigon, Giordano; Peyvandi, Flora; Rossio, Raffaella; Ferrari, Barbara; Colombo, Giulia; Agosti, Pasquale; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Ceriani, Giuliana; Salerno, Francesco; Pallini, Giada; Dallegri, Franco; Ottonello, Luciano; Liberale, Luca; Caserza, Lara; Salam, Kassem; Liberato, Nicola Lucio; Tognin, Tiziana; Bianchi, Giovanni Battista; Giaquinto, Sabrina; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Rozzini, Renzo; Falanga, Lina; Spazzini, Elena; Ferrandina, Camillo; Montrucchio, Giuseppe; Petitti, Paolo; Peasso, Paolo; Favale, Edoardo; Poletto, Cesare; Salmi, Raffaella; Gaudenzi, Piergiorgio; Violi, Francesco; Perri, Ludovica; Landolfi, Raffaele; Montalto, Massimo; Mirijello, Antonio; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Campiotti, Leonardo; Grossi, Alessandra; Bertolotti, Marco; Mussi, Chiara; Lancellotti, Giulia; Libbra, Maria Vittoria; Dondi, Giulia; Pellegrini, Elisa; Carulli, Lucia; Galassi, Matteo; Grassi, Yasmine; Perticone, Maria; Battaglia, Rosa; Filice, Marco; Maio, Raffaele; Stanghellini, Vincenzo; Ruggeri, Eugenio; del Vecchio, Sara; Salvi, Andrea; Leonardi, Roberto; Damiani, Giampaolo; Capeci, William; Gabrielli, Armando; Mattioli, Massimo; Martino, Giuseppe Pio; Biondi, Lorenzo; Pettinari, Pietro; Ghio, Riccardo; Col, Anna Dal; Minisola, Salvatore; Colangelo, Luciano; Cilli, Mirella; Labbadia, Giancarlo; Afeltra, Antonella; Marigliano, Benedetta; Pipita, Maria Elena; Castellino, Pietro; Zanoli, Luca; Pignataro, Samuele; Gennaro, Alfio; Blanco, Julien; Saracco, Valter; Fogliati, Marisa; Bussolino, Carlo; Mete, Francesca; Gino, Miriam; Cittadini, Antonio; Vigorito, Carlo; Arcopinto, Michele; Salzano, Andrea; Bobbio, Emanuele; Marra, Alberto Maria; Sirico, Domenico; Moreo, Guido; Gasparini, Francesca; Prolo, Silvia; Pina, Gloria; Ballestrero, Alberto; Ferrando, Fabio; Berra, Sergio; Dassi, Simonetta; Nava, Maria Cristina; Graziella, Bruno; Baldassarre, Stefano; Fragapani, Salvatore; Gruden, Gabriella; Galanti, Giorgio; Mascherini, Gabriele; Petri, Cristian; Stefani, Laura; Girino, Margherita; Piccinelli, Valeria; Nasso, Francesco; Gioffrè, Vincenza; Pasquale, Maria; Scattolin, Giuseppe; Martinelli, Sergio; Turrin, Mauro; Sechi, Leonardo; Catena, Cristina; Colussi, Gianluca; Passariello, Nicola; Rinaldi, Luca; Berti, Franco; Famularo, Giuseppe; Tarsitani, Patrizia; Castello, Roberto; Pasino, Michela; Ceda, Gian Paolo; Maggio, Marcello Giuseppe; Morganti, Simonetta; Artoni, Andrea; Del Giacco, Stefano; Firinu, Davide; Losa, Francesca; Paoletti, Giovanni; Costanzo, Giulia; Montalto, Giuseppe; Licata, Anna; Malerba, Valentina; Montalto, Filippo Alessandro; Lasco, Antonino; Basile, Giorgio; Catalano, Antonino; Malatino, Lorenzo; Stancanelli, Benedetta; Terranova, Valentina; Di Marca, Salvatore; Di Quattro, Rosario; La Malfa, Lara; Caruso, Rossella; Mecocci, Patrizia; Ruggiero, Carmelinda; Boccardi, Virginia; Meschi, Tiziana; Lauretani, Fulvio; Ticinesi, Andrea; Nouvenne, Antonio; Minuz, Pietro; Fondrieschi, Luigi; Pirisi, Mario; Fra, Gian Paolo; Sola, Daniele; Porta, Massimo; Riva, Piero; Quadri, Roberto; Larovere, Erica; Novelli, Marco; Scanzi, Giorgio; Mengoli, Caterina; Provini, Stella; Ricevuti, Laura; Simeone, Emilio; Scurti, Rosa; Tolloso, Fabio; Tarquini, Roberto; Valoriani, Alice; Dolenti, Silvia; Vannini, Giulia; Tedeschi, Alberto; Trotta, Lucia; Volpi, Riccardo; Bocchi, Pietro; Vignali, Alessandro; Harari, Sergio; Lonati, Chiara; Cattaneo, Mara; Napoli, Federico. - In: ACTA DIABETOLOGICA. - ISSN 0940-5429. - 58:9(2021), pp. 1225-1236. [10.1007/s00592-021-01716-8]
Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry
Paciullo, Francesco;De Luca, Giacomo;Damanti, Sarah;Pasquale, Maria;
2021-01-01
Abstract
Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged >= 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level >= 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia >= 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia >= 250 and < 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia >= 250 mg/dL (OR 2.07; [95% CI 1.34-3.19]), Barthel Index <= 40 (3.28[2.44-4.42]), CIRS-SI (1.87[1.27-2.77]), and male sex (1.54[1.16-2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level >= 250 mg/dL, Barthel Index <= 40, CIRS-SI, and male sex.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
