Association of inpatient and outpatient glucose management with inpatient mortality among patients with and without diabetes at a major academic medical center

摘要: BACKGROUND Hospitalized patients with diabetes have experienced a disproportionate reduction in mortality over the past decade. OBJECTIVE To examine whether this differential decrease affected all diabetes, and to identify explanatory factors. DESIGN Serial, cross-sectional observational study. SETTING Academic medical center. PATIENTS All adult, nonobstetric an inpatient discharge between January 1, 2000 December 31, 2010. MEASUREMENT We assessed in-hospital mortality; glycemic control (percentage of hospital days glucose below 70, above 299, 70 179 mg/dL, standard deviation measurements), outpatient (hemoglobin A1c). RESULTS We analyzed 322,938 admissions, including 76,758 (23.8%) diabetes. Among 54,645 intensive care unit (ICU) there was 7.8% relative odds each successive year for adjusted age, race, payer, length stay, diagnosis, comorbidities, service (odds ratio [OR]: 0.923, 95% confidence interval [CI]: 0.906-0.940). This significantly greater than 2.6% yearly those without (OR: 0.974, CI: 0.963-0.985; P < 0.001 interaction). In contrast, among non-ICU did not reach significance. Results were similar surgical patients. ICU significant decline persisted after adjustment 0.953, 0.914-0.994). CONCLUSIONS Patients that is explained by control. Potential explanations include improved cardiovascular risk management or advances therapies diseases commonly affecting Journal Hospital Medicine 2015;10:228–235. © 2015 Society