The prognostic significance of admission blood glucose levels in elderly patients with pneumonia (GAP Study)

AimsEvaluate the association between admission blood glucose (ABG) and short and long-term mortality following hospitalization for pneumonia of elderly patients with and without diabetes mellitus (DM).MethodsObservational data derived from the electronic records of hospitalized patients ≥ 65 years, admitted for pneumonia between January 2011 and December 2013. ABG levels were classified to categories: ≤ 70 (low), 70–110 (normal), 111–140 (mildly elevated), 141–199 mg/dl (moderately elevated) and ≥ 200 mg/dl (markedly elevated). Main outcomes were all-cause mortality rates at various time points.ResultsCohort included 2164 patients, 743 with DM (mean age 81, 53% male) and 1421 without it (mean age 83, 52% male). There was a significant interaction between DM, ABG and mortality (p ≤ 0.05). In patients without DM, compared with normal ABG, in-hospital and 30-day mortality rates (adjusted hazard ratio, 95% CI) were higher with moderately (1.5 and 1.4, respectively, p < 0.05) and markedly elevated ABG (2.7 and 1.9, respectively, p < 0.05). Long-term results were similar at 12 and 36 months (1.3 and 1.8, respectively, p < 0.05, for moderately and markedly elevated ABG).ConclusionIn elderly non-diabetic patients hospitalized for pneumonia, moderately and markedly elevated ABG is associated with increased short- and long-term mortality. In diabetic patients there is no association between ABG and mortality.