TY - JOUR
T1 - Hyperglycemia is associated with poor outcomes in surgical critically ill patients receiving parenteral nutrition
AU - Yan, Chiu Lan
AU - Huang, Yaw Bin
AU - Chen, Chih Yen
AU - Huang, Go Shine
AU - Yeh, Ming Kung
AU - Liaw, Wen Jinn
N1 - Funding Information:
The authors thank Miss Liu Jo-Hsiang (Institutional Review Board of Tri-Service General Hospital) and Mr. Chou Yu-Ching (School of Public Health, National Defense Medical Center) for their kind assistance in statistics. This study was supported in part by grants DOD97-T09-04 and TSGH-C100-064 from Tri-Service General Hospital, Taipei, Taiwan .
PY - 2013/6
Y1 - 2013/6
N2 - Background and aims Hyperglycemia, a major side effect of patients receiving total parenteral nutrition (PN), is associated with higher mortality in critically ill patients. The aim of this study was to determine whether elevated blood glucose levels would be associated with worse outcomes in patients receiving PN. Methods This retrospective study included postoperative patients admitted to our surgical intensive care unit (SICU) from July 2008 to June 2009. Data collected included blood glucose levels, length of stay, and outcome measures. Correlations among daily average, maximum, and minimum blood glucose levels and outcome measures were calculated. Results Sixty-nine patients were enrolled and divided into PN (n = 40) and non-PN (n = 29) groups. The initial mean blood glucose levels were 138.4 ± 63.1 mg/dL and 123.2 ± 41.8 mg/dL for the PN and non-PN groups, respectively. The mean blood glucose concentration was significantly increased (ΔBS = 44.8 ± 57.3 mg/dL; p < 0.001) in the PN group compared with the non-PN group (ΔBS = 39.4 ± 67.0 mg/dL; p = 0.004). The blood glucose concentration was significantly increased and consequently, consumption of insulin was increased on the 2nd day of ICU admission. The risk of mortality increased by a factor of 1.3 (OR = 1.30, 95% CI = 1.07-1.59, p = 0.010) for each 10 mg/dL increase in blood glucose level, when the daily maximum blood glucose level was >250 mg/dL. There were no cases of mortality in the current study when the blood glucose levels were controlled below 180 mg/dL. The mean blood glucose level in patients receiving PN was higher in those with diabetes than in those without diabetes (215.5 ± 42.8 vs. 165.8 ± 42.0 mg/dL, respectively, p = 0.001). Conclusion The blood glucose level was associated with patient outcome and should be intensively monitored in critically ill surgical patients. We suggest that blood glucose levels should be controlled below 180 mg/dL in postoperative critically ill patients.
AB - Background and aims Hyperglycemia, a major side effect of patients receiving total parenteral nutrition (PN), is associated with higher mortality in critically ill patients. The aim of this study was to determine whether elevated blood glucose levels would be associated with worse outcomes in patients receiving PN. Methods This retrospective study included postoperative patients admitted to our surgical intensive care unit (SICU) from July 2008 to June 2009. Data collected included blood glucose levels, length of stay, and outcome measures. Correlations among daily average, maximum, and minimum blood glucose levels and outcome measures were calculated. Results Sixty-nine patients were enrolled and divided into PN (n = 40) and non-PN (n = 29) groups. The initial mean blood glucose levels were 138.4 ± 63.1 mg/dL and 123.2 ± 41.8 mg/dL for the PN and non-PN groups, respectively. The mean blood glucose concentration was significantly increased (ΔBS = 44.8 ± 57.3 mg/dL; p < 0.001) in the PN group compared with the non-PN group (ΔBS = 39.4 ± 67.0 mg/dL; p = 0.004). The blood glucose concentration was significantly increased and consequently, consumption of insulin was increased on the 2nd day of ICU admission. The risk of mortality increased by a factor of 1.3 (OR = 1.30, 95% CI = 1.07-1.59, p = 0.010) for each 10 mg/dL increase in blood glucose level, when the daily maximum blood glucose level was >250 mg/dL. There were no cases of mortality in the current study when the blood glucose levels were controlled below 180 mg/dL. The mean blood glucose level in patients receiving PN was higher in those with diabetes than in those without diabetes (215.5 ± 42.8 vs. 165.8 ± 42.0 mg/dL, respectively, p = 0.001). Conclusion The blood glucose level was associated with patient outcome and should be intensively monitored in critically ill surgical patients. We suggest that blood glucose levels should be controlled below 180 mg/dL in postoperative critically ill patients.
KW - critical Illness hyperglycemia mortality parenteral nutrition, total
UR - http://www.scopus.com/inward/record.url?scp=84882905086&partnerID=8YFLogxK
U2 - 10.1016/j.aat.2013.06.004
DO - 10.1016/j.aat.2013.06.004
M3 - Article
C2 - 23968657
AN - SCOPUS:84882905086
SN - 1875-4597
VL - 51
SP - 67
EP - 72
JO - Acta Anaesthesiologica Taiwanica
JF - Acta Anaesthesiologica Taiwanica
IS - 2
ER -
