Fasting Plasma Glucose Levels at the Time of Admission Predict 90-Day Mortality in Patients with Viral Pneumonia. A Prospective Study.

Abstract

To determine the effect of fasting plasma glucose (FPG) level at admission affects the 90-day mortality rate in patients with viral pneumonia. Two hundred fifty viral pneumonia patients were stratified into normal FPG (FPG<7.0 mmol/L), moderately-elevated FPG (FPG=7.0-14.0 mmol/L), and highly-elevated FPG groups (FPG≥14.0 mmol/L) according to the FPG level at the time of admission. The clinical characteristics, etiologies, and prognosis of different groups of patients were compared. Kaplan-Meier survival and Cox regression analyses were used to determine the relationship between the FPG level and 90-day all-cause mortality rate in patients with viral pneumonia. Patients in the moderately- and highly-elevated FPG groups had a higher proportion of severe disease and mortality compared with the normal FPG group (P<0.001). Kaplan-Meier survival analysis showed a significant trend toward higher mortality and increased cumulative risk at 30, 60, and 90 d in patients with an FPG=7.0-14.0 mmol/L and an FPG≥14 mmol/L (χ2=51. 77, P<0.001). Multivariate Cox regression analysis revealed that compared with an FPG<7.0 mmol/L, FPG=7.0 and 14.0 mmol/L (HR: 9.236, 95% CI: 1.106-77.119, P=0.040) and FPG≥14.0 mmol/L (HR: 25.935, 95% CI: 2.586-246.213, P=0.005) were independent risk factors for predicting the 90-day mortality rate in viral pneumonia patients. The higher the FPG level at admission in a patient with viral pneumonia, the higher the risk of all-cause mortality within 90 d.