The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population: a multicentre study

Phyo Kyaw Myint, Stephanie Owen, Lyndsay Pearce, Matthew F. Greig, Hui Sian Tay, Caroline McCormack, Kathryn McCarthy, Susan J. Moug, Michael J. Stechman, Jonathan Hewitt, Older Persons Surgical Outcomes Collaboration (OPSOC)

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Abstract

BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting.

METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L.

RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3%) had glucose levels recorded on admission. The number (%) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2% vs 2.7%), suggesting a potential type II error.

CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients.

Original languageEnglish
Pages (from-to)514-519
Number of pages6
JournalPostgraduate Medical Journal
Volume92
Issue number1091
Early online date24 Aug 2016
DOIs
Publication statusPublished - 1 Sep 2016

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Hyperglycemia
Multicenter Studies
Length of Stay
Mortality
Population
Glucose
Blood Glucose
Logistic Models
Wales
Scotland
England
Guidelines

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The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population : a multicentre study. / Myint, Phyo Kyaw; Owen, Stephanie; Pearce, Lyndsay; Greig, Matthew F.; Tay, Hui Sian; McCormack, Caroline; McCarthy, Kathryn; Moug, Susan J.; Stechman, Michael J.; Hewitt, Jonathan; Older Persons Surgical Outcomes Collaboration (OPSOC).

In: Postgraduate Medical Journal, Vol. 92, No. 1091, 01.09.2016, p. 514-519.

Research output: Contribution to journalArticle

Myint, PK, Owen, S, Pearce, L, Greig, MF, Tay, HS, McCormack, C, McCarthy, K, Moug, SJ, Stechman, MJ, Hewitt, J & Older Persons Surgical Outcomes Collaboration (OPSOC) 2016, 'The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population: a multicentre study', Postgraduate Medical Journal, vol. 92, no. 1091, pp. 514-519. https://doi.org/10.1136/postgradmedj-2015-133777
Myint, Phyo Kyaw ; Owen, Stephanie ; Pearce, Lyndsay ; Greig, Matthew F. ; Tay, Hui Sian ; McCormack, Caroline ; McCarthy, Kathryn ; Moug, Susan J. ; Stechman, Michael J. ; Hewitt, Jonathan ; Older Persons Surgical Outcomes Collaboration (OPSOC). / The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population : a multicentre study. In: Postgraduate Medical Journal. 2016 ; Vol. 92, No. 1091. pp. 514-519.
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title = "The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population: a multicentre study",
abstract = "BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting.METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L.RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3{\%}) had glucose levels recorded on admission. The number ({\%}) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2{\%} vs 2.7{\%}), suggesting a potential type II error.CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients.",
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TY - JOUR

T1 - The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population

T2 - a multicentre study

AU - Myint, Phyo Kyaw

AU - Owen, Stephanie

AU - Pearce, Lyndsay

AU - Greig, Matthew F.

AU - Tay, Hui Sian

AU - McCormack, Caroline

AU - McCarthy, Kathryn

AU - Moug, Susan J.

AU - Stechman, Michael J.

AU - Hewitt, Jonathan

AU - Older Persons Surgical Outcomes Collaboration (OPSOC)

N1 - Funding statement This research received no specific grant from any funding agency in the public, commercial or not-for-profit sector.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting.METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L.RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3%) had glucose levels recorded on admission. The number (%) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2% vs 2.7%), suggesting a potential type II error.CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients.

AB - BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting.METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L.RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3%) had glucose levels recorded on admission. The number (%) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2% vs 2.7%), suggesting a potential type II error.CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients.

U2 - 10.1136/postgradmedj-2015-133777

DO - 10.1136/postgradmedj-2015-133777

M3 - Article

C2 - 26961158

VL - 92

SP - 514

EP - 519

JO - Postgraduate Medical Journal

JF - Postgraduate Medical Journal

SN - 0032-5473

IS - 1091

ER -