Association of Multiple Glycemic Parameters at Hospital Admission with Mortality and Short-Term Outcomes in Acutely Poisoned Patients

Abstract

The prognostic value of multiple glycemic parameters in poisoned patients was never assessed. We aim to explore the effects of glucose variability on short-term outcomes in nondiabetic and diabetic patients acutely poisoned with undifferentiated xenobiotics. We performed a prospective observational study in a tertiary center for toxicology in northeastern Romania. Over the course of 3 years, we included 1076 adults, older than 18 years, admitted for acute poisoning with a xenobiotic. The mortality rate was 4.1%. The admission blood glucose level (BGL) predicted mortality (OR 1.015, 95% CI 1.011–1.019, p < 0.001) and complications (OR 1.005, 95%CI 1.001–1.009, p 0.02). The mean glucose level (MGL) after admission (OR 1.007, 95% CI 1.000–1.013, p 0.034) and coefficient of glucose variability (CV) were predictive for complications (OR 40.58, 95% CI 1.35–1220.52, p 0.033), using the same multivariable model. The receiver operating characteristic curve (ROC) analysis revealed that BGL had good predictive value for in-hospital mortality (area under the curve (AUC) = 0.744, 95%CI = 0.648–0.841, p < 0.001), and complications (AUC = 0.618, 95%CI = 0.584–0.653, p < 0.001). In patients acutely poisoned with xenobiotics, the BGL, MGL and CV can be useful as mortality and short-outcome predictors.

Reply to Ferrés-Padró et al. Comment on “Lionte et al. Association of Multiple Glycemic Parameters at Hospital Admission with Mortality and Short-Term Outcomes in Acutely Poisoned Patients. Diagnostics 2021, 11, 361”

“…Large observational studies have reported increasing trends of severe hypoglycemia, resulting in emergency visits or hospitalization, in the USA, Canada, England, and Japan, possibly related to the rising prevalence of diabetes in older people [6]. We showed that the admission blood glucose is important in predicting the outcomes of the hospitalized patients acutely poisoned with xenobiotics, regardless of diabetes status [1].…”

“…Thank you for the opportunity to respond to the issues raised by Ferrés-Padró et al in their recent letter to the editor. All authors would also like to thank Dr. Ferrés-Padró and his colleagues for their recognition of our work [1].…”

The relative risk of toxico-clinical parameters with respect to poisoning severity and outcomes in patients with acute poisoning

“…The previous study has been demonstrated that history of disease could predict the outcomes of hospitalized patients with acute poisoning. [ 11 38 ]…”

Comment on Lionte et al. Association of Multiple Glycemic Parameters at Hospital Admission with Mortality and Short-Term Outcomes in Acutely Poisoned Patients. Diagnostics 2021, 11, 361

“…We have read with great interest the article by Lionte et al, "Association of multiple glycemic parameters at hospital admission with mortality and short-term outcomes in acutely poisoned patients", recently published in your journal [1].…”