Why the study?
Does admission hyperglycemia or previously diagnosed diabetes mellitus affect survival in patients hospitalized with acute decompensated heart failure?
Does admission hyperglycemia or previously diagnosed diabetes mellitus affect survival in patients hospitalized with acute decompensated heart failure?
In patients with acute decompensated heart failure, admission hyperglycemia is associated with higher in-hospital mortality, whereas previously diagnosed diabetes confers a greater risk of post-discharge mortality.
Answers are grounded in this paper and cite their sources.
Admission hyperglycemia marks highest in-hospital mortality in ADHF; leaves open whether glucose control improves outcomes.
BACKGROUND: Limited data are available about the characteristics, treatment and survival in patients without diabetes mellitus (DM), previously diagnosed DM and patients with hyperglycaemia who present with acute decompensated heart failure (ADHF). Our objectives were to examine differences in these endpoints in patients hospitalized with ADHF. METHODS: Patients hospitalized with ADHF during 1995, 2000, 2002 and 2004 comprised the study population. RESULTS: A total of 5428 non-diabetic patients were hospitalized with ADHF, 3807 with diagnosed DM and 513 with admission hyperglycaemia. Patients with admission hyperglycaemia experienced the highest in-hospital death rates (9.9%) compared to those with diagnosed DM (6.5%) and non-diabetics (7.5%). Patients with diagnosed DM had the greatest risk of dying after hospital discharge. CONCLUSIONS: Patients with elevated blood glucose levels at hospital admission are more likely to die acutely. After resolution of the acute illness, patients with previously diagnosed DM need careful monitoring and enhanced treatment.
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Helfand et al. (2014) studied this question.
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