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Abstract
Introduction Hypoglycemia is a significant clinical concern among hospitalized elderly patients, particularly those with acute illnesses such as pyelonephritis. It is associated with increased morbidity and mortality. Identifying specific risk factors for hypoglycemia in this vulnerable population is crucial to developing targeted interventions and improving patient outcomes. This study aimed to determine the risk factors associated with hypoglycemic events in elderly patients hospitalized with acute pyelonephritis. Methods This retrospective cohort study included 294 patients aged 65 years and older who were admitted to Unnan City Hospital with a diagnosis of acute pyelonephritis between January 2021 and April 2024. Data on demographic characteristics, comorbidities, and clinical outcomes were extracted from medical records. The primary outcome was the occurrence of hypoglycemia, defined as a blood glucose level below 70 mg/dL during hospitalization. Multivariate logistic regression analysis was performed to identify independent risk factors associated with hypoglycemic events. Results Hypoglycemia occurred in 146 (49.7%) of the 294 hospitalized patients. Lower body mass index (BMI) was significantly associated with an increased risk of hypoglycemia (OR = 0.84, 95% CI: 0.78-0.90, p < 0.00001). Age, sex, and comorbidities such as diabetes, heart failure, and chronic obstructive pulmonary disease did not significantly predict hypoglycemia risk. Hypoglycemic patients had a higher in-hospital mortality rate compared to non-hypoglycemic patients (46.6% vs. 31.1%, p = 0.008). Conclusions Lower BMI is an independent risk factor for hypoglycemia in elderly patients hospitalized with acute pyelonephritis. Early identification and tailored management of patients with low BMI could reduce the incidence of hypoglycemic events and improve clinical outcomes in this high-risk population.
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