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已发表论文
血糖变异性与慢性阻塞性肺疾病患者院内死亡率的关联：基于MIMIC-IV数据库的回顾性队列研究
Authors He J , Chen Y , Wang Q , Yu W , Zhang Y
Received 18 August 2025
Accepted for publication 19 January 2026
Published 23 January 2026 Volume 2026:21 561481
DOI https://doi.org/10.2147/COPD.S561481
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jill Ohar
Jiajia He,1 Yuxin Chen,1 Qian Wang,1 Wenhai Yu,1 Yongsheng Zhang2
1Second Clinical Medical College, Beijing University of Chinese Medicine, Beijing, 100078, People’s Republic of China; 2Department of International Medical Affairs, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, People’s Republic of China
Correspondence: Yongsheng Zhang, Department of International Medical Affairs, Dongfang Hospital, Beijing University of Chinese Medicine, Office 708, North Branch, East Building, Dongfang Hospital, Fangzhuang Fangxingyuan District 1, Fengtai District, Beijing, 100078, People’s Republic of China, Tel +86 13681298389, Email zhyshengcm@163.com
Purpose: The association between glycemic variability (GV) and the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD) remains uncertain. This study aimed to assess the connection between GV and hospital mortality among hospitalized COPD patients.
Patients and Methods: Data from the MIMIC-IV database were used in this study. GV was analyzed as a continuous variable and in quartiles. Cox proportional hazards modeling with stepwise adjustment was used to assess the link between GV and in-hospital mortality, and HRs and 95% CIs were calculated. A restricted cubic spline model was applied to explore non-linear associations. Survival curves and Log rank tests were performed to assess survival differences. Subgroup analyses and interaction tests were conducted to determine the relationship across diverse populations.
Results: Our analysis encompassed 11873 patients, among whom 838 individuals died during their hospitalization. A significant association between GV and in-hospital mortality in COPD patients was found across all Cox proportional hazards models: the unadjusted model (HR [95% CI]: 1.849 [1.409, 2.427], P < 0.001), the partially adjusted model (HR [95% CI]: 1.880 [1.432, 2.468], P < 0.001), and the fully adjusted model (HR [95% CI]: 1.551 [1.110, 2.167], P = 0.01). The restricted cubic spline (RCS) models revealed a significant non-linear relationship (P-nonlinear < 0.001). Survival curves demonstrated significant differences in in-hospital survival rates across varying GV levels (log-rank P < 0.0001).
Conclusion: GV exhibited a strong association with in-hospital mortality among COPD patients, and significant differences were observed in in-hospital survival rates across varying GV levels.
Keywords: chronic obstructive pulmonary disease, in-hospital mortality, glycemic variability, MIMIC-IV database
1Second Clinical Medical College, Beijing University of Chinese Medicine, Beijing, 100078, People’s Republic of China; 2Department of International Medical Affairs, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, People’s Republic of China
Correspondence: Yongsheng Zhang, Department of International Medical Affairs, Dongfang Hospital, Beijing University of Chinese Medicine, Office 708, North Branch, East Building, Dongfang Hospital, Fangzhuang Fangxingyuan District 1, Fengtai District, Beijing, 100078, People’s Republic of China, Tel +86 13681298389, Email zhyshengcm@163.com
Purpose: The association between glycemic variability (GV) and the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD) remains uncertain. This study aimed to assess the connection between GV and hospital mortality among hospitalized COPD patients.
Patients and Methods: Data from the MIMIC-IV database were used in this study. GV was analyzed as a continuous variable and in quartiles. Cox proportional hazards modeling with stepwise adjustment was used to assess the link between GV and in-hospital mortality, and HRs and 95% CIs were calculated. A restricted cubic spline model was applied to explore non-linear associations. Survival curves and Log rank tests were performed to assess survival differences. Subgroup analyses and interaction tests were conducted to determine the relationship across diverse populations.
Results: Our analysis encompassed 11873 patients, among whom 838 individuals died during their hospitalization. A significant association between GV and in-hospital mortality in COPD patients was found across all Cox proportional hazards models: the unadjusted model (HR [95% CI]: 1.849 [1.409, 2.427], P < 0.001), the partially adjusted model (HR [95% CI]: 1.880 [1.432, 2.468], P < 0.001), and the fully adjusted model (HR [95% CI]: 1.551 [1.110, 2.167], P = 0.01). The restricted cubic spline (RCS) models revealed a significant non-linear relationship (P-nonlinear < 0.001). Survival curves demonstrated significant differences in in-hospital survival rates across varying GV levels (log-rank P < 0.0001).
Conclusion: GV exhibited a strong association with in-hospital mortality among COPD patients, and significant differences were observed in in-hospital survival rates across varying GV levels.
Keywords: chronic obstructive pulmonary disease, in-hospital mortality, glycemic variability, MIMIC-IV database