Blood glucose on admission and mortality in patients with venous thromboembolism

Evaluate association between admission blood glucose (ABG) and mortality in patients with or without diabetes mellitus (DM) hospitalized for venous thromboembolism (VTE).

Observational data derived from the electronic records of hospitalized patients ≥18years, admitted for VTE (including deep vein thrombosis and pulmonary embolism) between January 2011 and December 2013. ABG levels were classified to categories: ≤70 (low), 70-110 (normal), 111-140 (mildly elevated), 141-180mg/dl (moderately elevated) and>180mg/dl (markedly elevated). Main outcome was all-cause mortality at the end of follow-up. We had complete follow-up data at 12months for all patients; median follow-up time was 1126days.

Cohort included 567 patients, 137 with (mean age 73, 45% male), and 430 without DM (mean age 65, 40% male). There was a significant interaction between DM, ABG and mortality (p≤0.05). In patients without DM there was a significant association between ABG and mortality: [hazard ratios 1.6, 2.3, and 4.7 respectively for mildly, moderately and markedly elevated ABG (p≤0.01)]. A significant association between ABG and mortality persisted following multivariable analysis only in patients with markedly elevated ABG (HR=2.3 95% CI 1.2-4.5). Similar results were evident in patients with deep vein thrombosis or pulmonary embolism. In patients with DM there was no significant association between ABG and mortality.

In patients without DM hospitalized for VTE, markedly elevated ABG is associated with increased mortality.