Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach
Abstract
:1. Background
2. Methods
2.1. Ethics Statement
2.2. Data Source and Study Population
2.3. Statistical Analysis
3. Results
3.1. Characteristics of the Patients
3.2. Outcomes of the Patients
3.3. Adjusted Outcomes of the Propensity Score-Matched Patients
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variables | NDN (n = 7806) | DN (n = 950) | SIH (n = 493) | DH (n = 897) |
---|---|---|---|---|
Sex | ||||
Male | 4605 (59.0) | 436 (45.9) | 287 (58.2) | 388 (43.3) |
Female | 3201 (41.0) | 514 (54.1) | 206 (41.8) | 509 (56.7) |
Age | 51.7 ± 19.3 | 67.9 ± 12.3 | 56.7 ± 18.0 | 65.8 ± 12.4 |
Comorbidity | ||||
HTN | 1697 (21.7) | 624 (65.7) | 128 (26.0) | 544 (60.6) |
CAD | 207 (2.7) | 92 (9.7) | 15 (3.0) | 87 (9.7) |
CHF | 54 (0.7) | 20 (2.1) | 3 (0.6) | 23 (2.6) |
CVA | 224 (2.9) | 113 (11.9) | 11 (2.2) | 83 (9.3) |
ESRD | 7 (0.1) | 1 (0.1) | 0 (0.0) | 3 (0.3) |
ISS, median (IQR) | 9 (4–10) | 9 (4–9) | 13 (9–24) | 9 (5–13) |
<16 | 6483 (83.1) | 797 (83.9) | 272 (55.2) | 700 (78.0) |
16–24 | 953 (12.2) | 114 (12.0) | 104 (21.1) | 134 (14.9) |
≥25 | 370 (4.7) | 39 (4.1) | 117 (23.7) | 63 (7.0) |
Mortality, n (%) | 151 (1.9) | 24 (2.5) | 96 (19.5) | 41 (4.6) |
Hospital LOS (days) | 9.6 ± 10.1 | 10.7 ± 10.5 | 14.1 ± 16.7 | 12.1 ± 11.8 |
ICU admission, n (%) | 1560 (20.0) | 213 (22.4) | 229 (46.5) | 218 (24.3) |
Pneumonia | 90 (1.2) | 31 (3.3) | 16 (3.2) | 26 (2.9) |
Acute renal failure | 27 (0.3) | 13 (1.4) | 8 (1.6) | 7 (0.8) |
Variables | DN vs. NDN | SIH vs. NDN | DH vs. NDN | SIH vs. DH | ||||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Sex | <0.001 | 0.733 | <0.001 | <0.001 | ||||
Male | 0.6 (0.52–0.68) | 1.0 (0.81–1.17) | 0.5 (0.46–0.61) | 0.6 (0.52–0.68) | ||||
Female | 1.7 (1.48–1.94) | 1.0 (0.86–1.24) | 1.9 (1.64–2.17) | 1.7 (1.48–1.94) | ||||
Age | - | <0.001 | - | <0.001 | - | <0.001 | - | <0.001 |
Comorbidity | ||||||||
HTN | 6.9 (5.96–7.96) | <0.001 | 1.3 (1.03–1.56) | 0.028 | 5.5 (4.80–6.41) | <0.001 | 6.9 (5.96–7.96) | <0.001 |
CAD | 3.9 (3.05–5.08) | <0.001 | 1.2 (0.68–1.96) | 0.602 | 3.9 (3.04–5.12) | <0.001 | 3.9 (3.05–5.08) | <0.001 |
CHF | 3.1 (1.84–5.18) | <0.001 | 0.9 (0.27–2.82) | 1.000 | 3.8 (2.31–6.19) | <0.001 | 3.1 (1.84–5.18) | <0.001 |
CVA | 4.6 (3.61–5.79) | <0.001 | 0.8 (0.42–1.43) | 0.407 | 3.5 (2.66–4.49) | <0.001 | 4.6 (3.61–5.79) | <0.001 |
ESRD | 1.2 (0.14–9.55) | 0.601 | - | 1.000 | 3.7 (0.97–14.48) | 0.075 | 1.2 (0.14–9.55) | 0.601 |
ISS, median (IQR) | - | <0.001 | - | <0.001 | - | <0.001 | - | <0.001 |
<16 | 1.1 (0.89–1.28) | 0.512 | 0.3 (0.21–0.30) | <0.001 | 0.7 (0.61–0.86) | <0.001 | 1.1 (0.89–1.28) | 0.512 |
16–24 | 1.0 (0.80–1.21) | 0.853 | 1.9 (1.53–2.41) | <0.001 | 1.3 (1.04–1.54) | 0.019 | 1.0 (0.80–1.21) | 0.853 |
≥25 | 0.9 (0.61–1.21) | 0.381 | 6.3 (4.96–7.89) | <0.001 | 1.5 (1.15–2.00) | 0.003 | 0.9 (0.61–1.21) | 0.381 |
Mortality, n (%) | 1.3 (0.85–2.03) | 0.218 | 12.3 (9.31–16.14) | <0.001 | 2.4 (1.71–3.45) | <0.001 | 1.3 (0.85–2.03) | 0.218 |
Hospital LOS (days) | - | 0.004 | - | <0.001 | - | <0.001 | - | 0.004 |
ICU admission, n (%) | 1.2 (0.98–1.36) | 0.078 | 3.5 (2.89–4.18) | <0.001 | 1.3 (1.09–1.51) | 0.002 | 1.2 (0.98–1.36) | 0.078 |
Pneumonia | 2.9 (1.91–4.38) | <0.001 | 2.9 (1.68–4.93) | <0.001 | 2.6 (1.65–3.98) | <0.001 | 2.9 (1.91–4.38) | <0.001 |
Acute renal failure | 4.0 (2.06–7.77) | <0.001 | 4.8 (2.15–10.52) | 0.001 | 2.3 (0.98–5.22) | 0.079 | 4.0 (2.06–7.77) | <0.001 |
Propensity-Score-Matched Cohort | ||||
---|---|---|---|---|
DN vs. NDN | DN (n = 934) | NDN (n = 934) | OR (95% CI) | p |
Mortality, n (%) | 23 (2.5) | 21 (2.2) | 1.1 (0.61–1.98) | 0.763 |
Hospital LOS (days) | 10.6 ± 10.5 | 9.4 ± 9.4 | - | 0.010 |
ICU admission, n (%) | 207 (22.2) | 185 (19.8) | 1.3 (0.95–1.69) | 0.109 |
Pneumonia | 30 (3.2) | 17 (1.8) | 1.8 (0.98–3.34) | 0.056 |
Acute renal failure | 11 (1.2) | 2 (0.2) | 5.5 (1.22–24.81) | 0.027 |
SIH vs. NDN | SIH (n = 485) | NDN (n = 485) | OR (95% CI) | p |
Mortality, n (%) | 89 (18.4) | 30 (6.2) | 3.0 (1.96–4.49) | <0.001 |
Hospital LOS (days) | 14.1 ± 16.6 | 11.0 ± 14.9 | - | 0.016 |
ICU admission, n (%) | 221 (45.6) | 194 (40.0) | 1.6 (1.10–2.30) | 0.014 |
Pneumonia | 15 (3.1) | 11 (2.3) | 1.4 (0.62–3.15) | 0.416 |
Acute renal failure | 6 (1.2) | 1 (0.2) | 6.0 (0.72–49.84) | 0.097 |
DH vs. NDN | DH (n = 883) | NDN (n = 883) | OR (95% CI) | p |
Mortality, n (%) | 40 (4.5) | 25 (2.8) | 1.2 (0.99–1.38) | 0.065 |
Hospital LOS (days) | 12.0 ± 11.8 | 10.1 ± 10.1 | - | <0.001 |
ICU admission, n (%) | 214 (24.2) | 206 (23.3) | 1.1 (0.82–1.47) | 0.547 |
Pneumonia | 26 (2.9) | 19 (2.2) | 1.4 (0.76–2.47) | 0.299 |
Acute renal failure | 7 (0.8) | 4 (0.5) | 1.8 (0.51–5.98) | 0.372 |
SIH vs. DH | SIH (n = 366) | DH (n = 366) | OR (95% CI) | p |
Mortality, n (%) | 51 (13.9) | 21 (5.7) | 2.4 (1.46–4.04) | 0.001 |
Hospital LOS (days) | 12.7 ± 16.0 | 12.6 ± 13.1 | - | 0.872 |
ICU admission, n (%) | 130 (35.5) | 111 (30.3) | 1.5 (1.01–2.36) | 0.046 |
Pneumonia | 8 (2.2) | 13 (3.6) | 0.6 (0.26–1.49) | 0.280 |
Acute renal failure | 3 (0.8) | 4 (1.1) | 0.8 (0.17–3.35) | 0.706 |
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Rau, C.-S.; Wu, S.-C.; Chen, Y.-C.; Chien, P.-C.; Hsieh, H.-Y.; Kuo, P.-J.; Hsieh, C.-H. Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach. Int. J. Environ. Res. Public Health 2017, 14, 1161. https://doi.org/10.3390/ijerph14101161
Rau C-S, Wu S-C, Chen Y-C, Chien P-C, Hsieh H-Y, Kuo P-J, Hsieh C-H. Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach. International Journal of Environmental Research and Public Health. 2017; 14(10):1161. https://doi.org/10.3390/ijerph14101161
Chicago/Turabian StyleRau, Cheng-Shyuan, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, and Ching-Hua Hsieh. 2017. "Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach" International Journal of Environmental Research and Public Health 14, no. 10: 1161. https://doi.org/10.3390/ijerph14101161