Hospitalized patients with stress hyperglycemia: incidence of diabetes and mortality on follow-up.
INTRODUCTION
The study objective was to estimate during post-discharge follow-up the incidence of diabetes and to ascertain mortality in hospitalized patients, classified during follow-up as having stress hyperglycemia (SH) or normoglycemia (NG) based on blood glucose levels.


MATERIAL AND METHODS
A retrospective cohort of non-diabetic adults with SH (> 140mg/dl and HbA1c <6.5%) or NG (all blood glucose values ≤ 140mg/dl) was used.


RESULTS
There were 3981 patients with NG and 884 with SH. During the observation period (median follow-up of 1.83 years), there were 255 cases of diabetes and 831 deaths. The cumulative incidence of diabetes per year was 1.59% (95% CI: 1.23-2.06) in patients with NG and 7.39% (95% CI: 5.70-9.56) in those with SH. SH was significantly associated to diabetes (crude HR 1.33, 95% CI: 1.13-1.73, p .025), even after adjusting for age and sex (adjusted HR 1.38, 95% CI 1.06-1.78, p .014). The mortality rate at one year was 10.07% (95% CI: 9.18-11.05) in NG patients and 13.24% (95% CI: 11.17-15.65) in SH patients. The sub-hazard ratio of developing diabetes considering death as a competitive event was 1.41 (95% CI 1.29-1.53, p <.001).


CONCLUSIONS
SH is a risk factor for diabetes. There were no differences in mortality during follow-up, but death appears to be a competitive event in development of diabetes in this population.
['Russo|María Paula|MP|', 'Grande Ratti|María Florencia|MF|', 'Giunta|Diego Hernán|DH|', 'Elizondo|Cristina María|CM|']
D000368:Aged D000369:Aged, 80 and over D001118:Argentina D003920:Diabetes Mellitus D003953:Diagnosis-Related Groups D005260:Female D005500:Follow-Up Studies D006442:Glycated Hemoglobin A D017052:Hospital Mortality D006760:Hospitalization D006785:Hospitals, University D006801:Humans D006943:Hyperglycemia D015994:Incidence D007297:Inpatients D053208:Kaplan-Meier Estimate D007902:Length of Stay D008297:Male D008875:Middle Aged D016016:Proportional Hazards Models D012189:Retrospective Studies D012307:Risk Factors D013312:Stress, Physiological D062606:Tertiary Care Centers
Stress hyperglycemia Diabetes Mortality Hiperglucemia de estrés Mortalidad