ORIGINAL ARTICLE |
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Year : 2021 | Volume
: 4
| Issue : 1 | Page : 23-29 |
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Admission hyperglycemia and adverse clinical outcomes in critically ill patients: A prospective, observational study
Vishakha Jain1, Sunil Bade2, OP Gupta2
1 Department of Medicine, All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India 2 Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India
Correspondence Address:
Dr. Vishakha Jain Department of Medicine, AIIMS Bibinagar (Hyderabad Metropolitan Region), Hyderabad, Telangana 508126 India
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jdep.jdep_9_20
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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.
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