• Eur. J. Intern. Med. · Jan 2018

    Multicenter Study

    Derivation and validation model for hospital hypoglycemia.

    • Javier Ena, GaviriaAntonio ZapateroAZInternal Medicine Department, Hospital de Fuenlabrada, Madrid, Spain., Marta Romero-Sánchez, Juana Carretero-Gómez, Francisco Javier Carrasco-Sánchez, Segura-HerasJosé VicenteJVCentro de Investigación Operativa, Universidad Miguel Hernández, Sant Joan D'Alacant, Alicante, Spain., Ana Belkis Porto-Perez, Patricia Vázquez-Rodriguez, Concepción González-Becerra, Ricardo Gómez-Huelgas, and Diabetes and Obesity Working Group of the Spanish Society of Internal Medicine.
    • Internal Medicine Department, Hospital Marina Baixa, Alicante, Spain. Electronic address: ena_jav@gva.es.
    • Eur. J. Intern. Med. 2018 Jan 1; 47: 43-48.

    BackgroundAn objective and simple prognostic model for hospitalized patients with hypoglycemia could be helpful in guiding initial intensity of treatment.MethodsWe carried out a derivation rule for hypoglycemia using data from a nationwide retrospective cohort study of patients with diabetes or hyperglycemia carried out in 2014 (n=839 patients). The rule for hypoglycemia was validated using a second data set from a nationwide retrospective cohort study carried out in 2016 (n=561 patients). We derived our prediction rule using logistic regression with hypoglycemia (glucose less than 70mg/dL) as the primary outcome.ResultsThe incidence of hypoglycemia in the derivation cohort was 10.3%. Patient's characteristics independently associated with hypoglycemia included episodes of hypoglycemia during the previous three months (odds ratio [OR]: 6.29, 95% confidence interval [95%CI]: 3.37-11.79, p<0.001) estimated glomerular filtration rate lower than 30mL/min/1.73m2 (OR: 2.32, 95%CI: 1.23-4.35, p=0.009), daily insulin dose greater than 0.3units per Kg (OR: 1.74, 95%CI: 1.06-2.85, p=0.028), and days of hospitalization (OR: 1.03, 95%CI: 1.01-1.04, p=0.001). The model showed an area under the curve (AUC): 0.72 (95%CI: 0.66-0.78, p<0.001). The AUC in the validation cohort was: 0.71 (95%CI: 0.63-0.79, p<0.001).ConclusionsThe rule showed fair accuracy to predict hypoglycemia. Implementation of the rule into computer systems could be used in guiding initial insulin therapy.Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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