Tsung-Hsing Hung1,2, Chih-Wei Tseng1,2, Chih-Chun Tsai3, Hsing-Feng Lee4,5. 1. Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan. 2. School of Medicine, Tzu Chi University, Hualien, Taiwan. 3. Department of Mathematics, Tamkang University, Tamsui, Taiwan. 4. Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, Chiayi County, 62247, Taiwan. hflee1979@hotmail.com. 5. School of Medicine, Tzu Chi University, Hualien, Taiwan. hflee1979@hotmail.com.
Abstract
BACKGROUND: Studies have shown that hyperglycemia in cirrhotic patients increases mortality. However, no population-based study has evaluated the influence of hypoglycemia upon hospital admission on death in these patients. The aim of this study was to assess the effect of hypoglycemia at admission on the mortality of patients with liver cirrhosis. METHODS: The Taiwan National Health Insurance Database was searched, and 636 cirrhotic patients without baseline diabetes mellitus who presented with hypoglycemia upon hospitalized from 2010 to 2013 were included in the study. A one-to-four propensity score matching was performed to select a comparison group based on age, sex and comorbidities. RESULTS: The overall 30-day mortality rate was 30.2% in the hypoglycemia group and 7.4% in the non-hypoglycemia group (P < 0.001). After Cox regression modeling adjusting for age, sex and comorbid disorders, cirrhotic patients with hypoglycemia had a hazard ratio (HR) of 30-day mortality of 4.96 (95% confidence interval [CI] 4.05-6.08, P < 0.001) as compared to the non-hypoglycemia group. In subgroup analysis, the cirrhotic patients with hypoglycemia and hepatocellular carcinoma (HCC) had a 30-day mortality HR of 6.11 (95% confidence interval [CI] 4.40-8.49, P < 0.001) compared to those with neither hypoglycemia nor HCC. CONCLUSIONS: Hypoglycemia is a very important prognostic factor in the 30-day mortality of cirrhotic patients, especially in those with underlying HCC.
BACKGROUND: Studies have shown that hyperglycemia in cirrhotic patients increases mortality. However, no population-based study has evaluated the influence of hypoglycemia upon hospital admission on death in these patients. The aim of this study was to assess the effect of hypoglycemia at admission on the mortality of patients with liver cirrhosis. METHODS: The Taiwan National Health Insurance Database was searched, and 636 cirrhotic patients without baseline diabetes mellitus who presented with hypoglycemia upon hospitalized from 2010 to 2013 were included in the study. A one-to-four propensity score matching was performed to select a comparison group based on age, sex and comorbidities. RESULTS: The overall 30-day mortality rate was 30.2% in the hypoglycemia group and 7.4% in the non-hypoglycemia group (P < 0.001). After Cox regression modeling adjusting for age, sex and comorbid disorders, cirrhotic patients with hypoglycemia had a hazard ratio (HR) of 30-day mortality of 4.96 (95% confidence interval [CI] 4.05-6.08, P < 0.001) as compared to the non-hypoglycemia group. In subgroup analysis, the cirrhotic patients with hypoglycemia and hepatocellular carcinoma (HCC) had a 30-day mortality HR of 6.11 (95% confidence interval [CI] 4.40-8.49, P < 0.001) compared to those with neither hypoglycemia nor HCC. CONCLUSIONS:Hypoglycemia is a very important prognostic factor in the 30-day mortality of cirrhotic patients, especially in those with underlying HCC.
Authors: Uh Young Huh; Jin Hyuk Kim; Byung-Ho Kim; Ki Deuk Nam; Jae Young Jang; Nam Hoon Kim; Sang Kil Lee; Kwang Ro Joo; Seok Ho Dong; Hyo Jong Kim; Young Woon Chang; Joung Il Lee; Rin Chang Journal: Korean J Hepatol Date: 2005-09
Authors: Anupamaa Seshadri; Rachel Appelbaum; Samuel P Carmichael; Joseph Cuschieri; Jason Hoth; Krista L Kaups; Lisa Kodadek; Matthew E Kutcher; Abhijit Pathak; Joseph Rappold; Sean R Rudnick; Christopher P Michetti Journal: Trauma Surg Acute Care Open Date: 2022-08-01