Fasting hyperglycaemia and in‐hospital mortality in elderly population

Summary Background:  Admission hyperglycaemia has shown to be a marker of poor clinical outcome. The prevalence of admission hyperglycaemia and its relationship with in‐hospital mortality in elderly population has not been clearly defined. We assessed the prevalence and prognostic significance of admission fasting hyperglycaemia in aged patients. Methods:  A total of 808 elderly patients were studied. Patients were classified into group I (serum glucose < 126 mg/dl), II (126–180 mg/dl) and III (> 180 mg/dl). Groups II and III were considered newly recognised fasting hyperglycaemia (NRFH) in non‐diabetic patients. Results:  NRFH was present in 18.6%. After excluding diabetic patients ( n  = 206, 25.5%), the distribution of patients ( n  = 602, 74.5%) was as follows: group I ( n  = 452, 55.9%), group II ( n  = 122, 15.1%) and group III ( n  = 28, 3.5%). In the whole cohort, median fasting glucose was lower in patients who survived [105 mg/dl (88–135)] than in those who died [127 mg/dl (93–159), p < 0.001]. This significant difference was maintained only when non‐diabetic patients were considered [100 mg/dl (87–122) vs. 118 mg/dl (92–149), p < 0.001]. In‐hospital mortality rate in groups I, II and III was 8.5%, 14.1% and 22.9%, respectively (p < 0.001). Mortality rate was 8.4%, 18.0% and 32.1% (p < 0.001) in groups I, II and III, respectively in non‐diabetic population. Both low albumin and high glucose serum concentrations were the only independent risk factors for in‐hospital all‐cause mortality in non‐diabetic patients. Conclusions:  In non‐diabetic elderly patients admitted for acute disease, serum glucose concentration is an important, simple and independent predictor of hospital mortality.