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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2021; 04(01): 23-29
DOI: 10.4103/jdep.jdep_9_20
Original Article

Admission hyperglycemia and adverse clinical outcomes in critically ill patients: A prospective, observational study

Vishakha Jain
Department of Medicine, All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana
,
Sunil Bade
1   Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra
,
O Gupta
1   Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra
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Background: Admission hyperglycemia is known to cause increase in in-hospital mortality, increased length of intensive care unit (ICU) stay, increased morbidity across critically ill patients. In patients with vascular disease (myocardial infarction, stroke, etc.), this has been extensively studied. We planned to study the prevalence of admission hyperglycemia and its association with adverse outcomes in all critically ill patients. Methods: In an observational, prospective study, 200 critically ill inpatients admitted to the medicine ICU were included. The patients were stratified into known diabetes, newly detected diabetes, and stress hyperglycemia. Baseline clinical and laboratory parameters were collected, and Acute Physiology and Chronic Health Evaluation (APACHE)-II, Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology (SAP II) scores were calculated. Data regarding clinical outcomes (discharge or in-hospital death) were also collected. Results:   The prevalence of admission hyperglycemia and of stress hyperglycemia was found to be 11.99% and 1.51%, respectively. The newly detected diabetes had higher admission hyperglycemia and glycosylated hemoglobin. The prognostic scores – APACHE-II, SAP II, and SOFA scores – were worse among patients who died in the newly detected diabetes and the stress hyperglycemia group but not in the known diabetes group.   The odds of death increased by 3.5 times with 1-day increase in the ICU. Conclusion: Our study concluded that the patients with newly detected diabetes and stress hyperglycemia had more severe illness as compared to the known diabetics.

Keywords

Admission hyperglycemia - clinical outcomes - critically ill patients - diabetes mellitus - hyperglycemia - mortality - stress hyperglycemia

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 20. Mai 2020

Angenommen: 26. Juli 2020

Artikel online veröffentlicht:
06. Juli 2022

© 2021. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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