MORTALITY IN HOSPITALIZED-PATIENTS WITH HYPOGLYCEMIA AND SEVERE HYPERGLYCEMIA

Background: We designed a study to determine the incidence, cause, and implications of hypoglycemia (less than or equal to 2.7 mmol/L, 49 mg /dL) and severe hyperglycemia (greater than or equal to 22.2 mmol/L, 4 00 mg/dL) in in-patients at an urban tertiary medical center. Methods: A daily computer search of the Laboratory Information System identifi ed all hospitalized patients with hypoglycemia and severe hyperglycemi a during a 49-day period. Chart review was used to assess demographic information, risk factors, and epidemiologic variables. The eventual o utcome of the hospitalization was obtained by follow-up. Results: The incidence of hypoglycemia was 1.5%, and of hyperglycemia, 1.9%. Sevent y-six percent of the hypoglycemic patients and 16% of the hyperglycemi c patients had no prior history of diabetes. The mortality rate for hy poglycemic patients was 22.2%; for hyperglycemic patients it was 11.1% . For all other hospitalized patients it was 2.3% (p < 0.0001). Mortal ity rates for the black and Hispanic patients who were hypoglycemic (3 0% and 46%) were significantly higher than for white patients (6%, p < 0.01). Conclusions: Hypoglycemia and severe hyperglycemia are not unc ommon in hospitalized patients and serve as metabolic markers for pati ents at increased risk for in-hospital mortality. Early identification of at-risk patients and the impact of aggressive treatment of their u nderlying disease processes should be evaluated in future studies.