Abstract：
OBJECTIVE: In-hospital dysglycemia is associated with adverse outcomes. Identifying patients at risk of in-hospital dysglycemia early on admission may improve patient outcomes.
METHODS: We analysed 117 inpatients admitted with pneumonia and type 2 diabetes monitored by continuous glucose monitoring. We assessed potential risk factors for in-hospital dysglycemia and adverse clinical outcomes.
RESULTS: Time in range (3.9-10.0 mmol/l) decreased by 2.9 %-points [95 % CI 0.7-5.0] per 5 mmol/mol [2.6 %] increase in admission haemoglobin A1c, 16.2 %-points if admission diabetes therapy included insulin therapy [95 % CI 2.9-29.5], and 2.4 %-points [95 % CI 0.3-4.6] per increase in the Charlson Comorbidity Index (CCI) (integer, as a measure of severity and amount of comorbidities). Thirty-day readmission rate increased with an IRR of 1.24 [95 % CI 1.06-1.45] per increase in CCI. In-hospital mortality risk increased with an OR of 1.41 [95 % CI 1.07-1.87] per increase in Early Warning Score (EWS) (integer, as a measure of acute illness) at admission.
CONCLUSIONS: Dysglycemia among hospitalised patients with pneumonia and type 2 diabetes was associated with high haemoglobin A1c, insulin treatment before admission, and the amount and severity of comorbidities (i.e., CCI). Thirty-day readmission rate increased with high CCI. The risk of in-hospital mortality increased with the degree of acute illness (i.e., high EWS) at admission. Clinical outcomes were independent of chronic glycemic status, i.e. HbA1c, and in-hospital glycemic status.
METHODS: We analysed 117 inpatients admitted with pneumonia and type 2 diabetes monitored by continuous glucose monitoring. We assessed potential risk factors for in-hospital dysglycemia and adverse clinical outcomes.
RESULTS: Time in range (3.9-10.0 mmol/l) decreased by 2.9 %-points [95 % CI 0.7-5.0] per 5 mmol/mol [2.6 %] increase in admission haemoglobin A1c, 16.2 %-points if admission diabetes therapy included insulin therapy [95 % CI 2.9-29.5], and 2.4 %-points [95 % CI 0.3-4.6] per increase in the Charlson Comorbidity Index (CCI) (integer, as a measure of severity and amount of comorbidities). Thirty-day readmission rate increased with an IRR of 1.24 [95 % CI 1.06-1.45] per increase in CCI. In-hospital mortality risk increased with an OR of 1.41 [95 % CI 1.07-1.87] per increase in Early Warning Score (EWS) (integer, as a measure of acute illness) at admission.
CONCLUSIONS: Dysglycemia among hospitalised patients with pneumonia and type 2 diabetes was associated with high haemoglobin A1c, insulin treatment before admission, and the amount and severity of comorbidities (i.e., CCI). Thirty-day readmission rate increased with high CCI. The risk of in-hospital mortality increased with the degree of acute illness (i.e., high EWS) at admission. Clinical outcomes were independent of chronic glycemic status, i.e. HbA1c, and in-hospital glycemic status.
摘要：
目的：住院血糖异常与不良结局相关。在入院早期识别有住院血糖异常风险的患者可以改善患者的预后。
方法：我们分析了通过连续血糖监测监测的117例住院的肺炎和2型糖尿病患者。我们评估了住院血糖异常和不良临床结局的潜在危险因素。
结果：入院血红蛋白A1c每增加5mmol/mol[2.6%]，时间范围（3.9-10.0mmol/l）减少2.9个百分点[95%CI0.7-5.0]，16.2%-如果入院糖尿病治疗包括胰岛素治疗[95%CI2.9-29.5]，Charlson合并症指数(CCI)每增加2.4%点[95%CI0.3-4.6](整数，作为合并症的严重程度和数量的衡量标准)。30天再入院率每增加一次CCI，IRR为1.24[95%CI1.06-1.45]。院内死亡风险增加，预警评分(EWS)每增加1.41[95%CI1.07-1.87](整数，作为急性疾病的衡量标准)。
结论：肺炎和2型糖尿病住院患者的血糖异常与高血红蛋白A1c相关，入院前胰岛素治疗，以及合并症的数量和严重程度(即，CCI)。30天再入院率随CCI升高而升高。院内死亡的风险随着急性疾病程度的增加而增加(即，EWS较高)。临床结果独立于慢性血糖状态，即HbA1c，和住院血糖状态。
方法：我们分析了通过连续血糖监测监测的117例住院的肺炎和2型糖尿病患者。我们评估了住院血糖异常和不良临床结局的潜在危险因素。
结果：入院血红蛋白A1c每增加5mmol/mol[2.6%]，时间范围（3.9-10.0mmol/l）减少2.9个百分点[95%CI0.7-5.0]，16.2%-如果入院糖尿病治疗包括胰岛素治疗[95%CI2.9-29.5]，Charlson合并症指数(CCI)每增加2.4%点[95%CI0.3-4.6](整数，作为合并症的严重程度和数量的衡量标准)。30天再入院率每增加一次CCI，IRR为1.24[95%CI1.06-1.45]。院内死亡风险增加，预警评分(EWS)每增加1.41[95%CI1.07-1.87](整数，作为急性疾病的衡量标准)。
结论：肺炎和2型糖尿病住院患者的血糖异常与高血红蛋白A1c相关，入院前胰岛素治疗，以及合并症的数量和严重程度(即，CCI)。30天再入院率随CCI升高而升高。院内死亡的风险随着急性疾病程度的增加而增加(即，EWS较高)。临床结果独立于慢性血糖状态，即HbA1c，和住院血糖状态。
