Javier Ena1, Antonio Zapatero Gaviria2, Marta Romero-Sánchez2, Juana Carretero-Gómez3, Francisco Javier Carrasco-Sánchez4, José Vicente Segura-Heras5, Ana Belkis Porto-Perez6, Patricia Vázquez-Rodriguez6, Concepción González-Becerra7, Ricardo Gómez-Huelgas8. 1. Internal Medicine Department, Hospital Marina Baixa, Alicante, Spain. Electronic address: ena_jav@gva.es. 2. Internal Medicine Department, Hospital de Fuenlabrada, Madrid, Spain. 3. Internal Medicine Department, Hospital de Zafra, Badajoz, Spain. 4. Internal Medicine Department, Hospital Juan Ramón Jiménez, Huelva, Spain. 5. Centro de Investigación Operativa, Universidad Miguel Hernández, Sant Joan D'Alacant, Alicante, Spain. 6. Internal Medicine Department, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain. 7. Internal Medicine Department, Hospital San Juan de Dios, Tenerife. Spain. 8. Internal Medicine Department, Hospital Regional Universitario, FIMABIS, Málaga, Spain.
Abstract
BACKGROUND: An objective and simple prognostic model for hospitalized patients with hypoglycemia could be helpful in guiding initial intensity of treatment. METHODS: We carried out a derivation rule for hypoglycemia using data from a nationwide retrospective cohort study of patients with diabetes or hyperglycemia carried out in 2014 (n=839 patients). The rule for hypoglycemia was validated using a second data set from a nationwide retrospective cohort study carried out in 2016 (n=561 patients). We derived our prediction rule using logistic regression with hypoglycemia (glucose less than 70mg/dL) as the primary outcome. RESULTS: The incidence of hypoglycemia in the derivation cohort was 10.3%. Patient's characteristics independently associated with hypoglycemia included episodes of hypoglycemia during the previous three months (odds ratio [OR]: 6.29, 95% confidence interval [95%CI]: 3.37-11.79, p<0.001) estimated glomerular filtration rate lower than 30mL/min/1.73m2 (OR: 2.32, 95%CI: 1.23-4.35, p=0.009), daily insulin dose greater than 0.3units per Kg (OR: 1.74, 95%CI: 1.06-2.85, p=0.028), and days of hospitalization (OR: 1.03, 95%CI: 1.01-1.04, p=0.001). The model showed an area under the curve (AUC): 0.72 (95%CI: 0.66-0.78, p<0.001). The AUC in the validation cohort was: 0.71 (95%CI: 0.63-0.79, p<0.001). CONCLUSIONS: The rule showed fair accuracy to predict hypoglycemia. Implementation of the rule into computer systems could be used in guiding initial insulin therapy.
BACKGROUND: An objective and simple prognostic model for hospitalized patients with hypoglycemia could be helpful in guiding initial intensity of treatment. METHODS: We carried out a derivation rule for hypoglycemia using data from a nationwide retrospective cohort study of patients with diabetes or hyperglycemia carried out in 2014 (n=839 patients). The rule for hypoglycemia was validated using a second data set from a nationwide retrospective cohort study carried out in 2016 (n=561 patients). We derived our prediction rule using logistic regression with hypoglycemia (glucose less than 70mg/dL) as the primary outcome. RESULTS: The incidence of hypoglycemia in the derivation cohort was 10.3%. Patient's characteristics independently associated with hypoglycemia included episodes of hypoglycemia during the previous three months (odds ratio [OR]: 6.29, 95% confidence interval [95%CI]: 3.37-11.79, p<0.001) estimated glomerular filtration rate lower than 30mL/min/1.73m2 (OR: 2.32, 95%CI: 1.23-4.35, p=0.009), daily insulin dose greater than 0.3units per Kg (OR: 1.74, 95%CI: 1.06-2.85, p=0.028), and days of hospitalization (OR: 1.03, 95%CI: 1.01-1.04, p=0.001). The model showed an area under the curve (AUC): 0.72 (95%CI: 0.66-0.78, p<0.001). The AUC in the validation cohort was: 0.71 (95%CI: 0.63-0.79, p<0.001). CONCLUSIONS: The rule showed fair accuracy to predict hypoglycemia. Implementation of the rule into computer systems could be used in guiding initial insulin therapy.
Authors: Nestoras Nicolas Mathioudakis; Estelle Everett; Shuvodra Routh; Peter J Pronovost; Hsin-Chieh Yeh; Sherita Hill Golden; Suchi Saria Journal: BMJ Open Diabetes Res Care Date: 2018-03-02
Authors: Nestoras N Mathioudakis; Mohammed S Abusamaan; Ahmed F Shakarchi; Sam Sokolinsky; Shamil Fayzullin; John McGready; Mihail Zilbermint; Suchi Saria; Sherita Hill Golden Journal: JAMA Netw Open Date: 2021-01-04
Authors: Luis M Pérez-Belmonte; Juan J Gómez-Doblas; Mercedes Millán-Gómez; María D López-Carmona; Ricardo Guijarro-Merino; Fernando Carrasco-Chinchilla; Eduardo de Teresa-Galván; Manuel Jiménez-Navarro; M Rosa Bernal-López; Ricardo Gómez-Huelgas Journal: J Clin Med Date: 2018-09-11 Impact factor: 4.241