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. 2006 Apr;61(4):284-9.
doi: 10.1136/thx.2005.051029. Epub 2006 Jan 31.

Hyperglycaemia is associated with poor outcomes in patients admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease

E H Baker  1 , C H Janaway, B J Philips, A L Brennan, D L Baines, D M Wood, P W Jones
Affiliations

Hyperglycaemia is associated with poor outcomes in patients admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease

E H Baker et al. Thorax. 2006 Apr.

Abstract

Background: Hyperglycaemia is associated with poor outcomes from pneumonia, myocardial infarction and stroke, but the effect of blood glucose on outcomes from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been established. Recent UK guidelines do not comment on measurement or control of blood glucose in AECOPD. A study was therefore undertaken to determine the relationship between blood glucose concentrations, length of stay in hospital, and mortality in patients admitted with AECOPD.

Methods: Data were retrieved from electronic records for patients admitted with AECOPD with lower respiratory tract infection in 2001-2. The patients were grouped according to blood glucose quartile (group 1, <6 mmol/l (n = 69); group 2, 6.0-6.9 mmol/l (n = 69); group 3, 7.0-8.9 mmol/l (n = 75); and group 4, >9.0 mmol/l (n = 71)).

Results: The relative risk (RR) of death or long inpatient stay was significantly increased in group 3 (RR 1.46, 95% CI 1.05 to 2.02, p = 0.02) and group 4 (RR 1.97, 95% CI 1.33 to 2.92, p < 0.0001) compared with group 1. For each 1 mmol/l increase in blood glucose the absolute risk of adverse outcomes increased by 15% (95% CI 4 to 27), p = 0.006. The risk of adverse outcomes increased with increasing hyperglycaemia independent of age, sex, a previous diagnosis of diabetes, and COPD severity. Isolation of multiple pathogens and Staphylococcus aureus from sputum also increased with increasing blood glucose.

Conclusion: Increasing blood glucose concentrations are associated with adverse clinical outcomes in patients with AECOPD. Tight control of blood glucose reduces mortality in patients in intensive care or following myocardial infarction. A prospective study is now required to determine whether control of blood glucose can also improve outcomes from AECOPD.

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Conflict of interest statement

Competing interests: none.

Comment in

References

    1. Soriano J B, Maier W C, Egger P.et al Recent trends in physician diagnosed COPD in women and men in the UK. Thorax 200055789–794. - PMC - PubMed
    1. National Collaborating Centre for Chronic Conditions National clinical guidelines on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax 200459(Suppl I)1–232. - PMC - PubMed
    1. Warren P M, Flenley D C, Millar J S.et al Respiratory failure revisited: acute excacerbations of chronic bronchitis between 1961–68 and 1970–76. Lancet 19801467–470. - PubMed
    1. Patil S P, Krishnan J A, Lechtzin N.et al In‐hospital mortality following acute exacerbations of chronic obstructive pulmonary disease. Arch Intern Med 20031631180–1186. - PubMed
    1. Umpierrez G E, Isaacs S D, Bazargan H.et al Hyperglycemia: an independent marker of in‐hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 200287978–982. - PubMed