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Hyperglycaemia and mortality in critically ill patients

A prospective study

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Abstract

Objective

To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU.

Design

Prospective cohort study.

Setting

A 13-bed non-cardiac multidisciplinary ICU in a university hospital.

Patients and participants

Adult patients consecutively admitted to the ICU in a 6-month period. Patients with fewer than 2 days’ stay in the ICU and patients with known diabetes were excluded.

Measurements and results

At admission a registration form was filled in including demographic data, first and second day APACHE II scores, infections and daily maximum blood glucose level. In surgical patients, high maximum blood glucose level during the stay in ICU was correlated with increased mortality, morbidity and frequency of infection. In medical patients, we found a non-significant trend towards a correlation between hyperglycaemia and morbidity and mortality, respectively.

Conclusions

High blood glucose level during the stay in ICU was a marker of increased morbidity and mortality in critically ill surgical patients. In medical patients the same trend was found, but non-significant. The population of patients in the present study are heterogeneous and the results from surgical critically ill patients should not be generalised to medical patients.

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References

  1. Mizock BA (1995) Alterations in carbohydrate metabolism during stress: a review of the literature. Am J Med 98:75–84

    Article  CAS  PubMed  Google Scholar 

  2. Mizock BA (2001) Alterations in fuel metabolism in critical illness: hyperglycaemia. Best Pract Res Clin Endocrinol Metab 15:533–551

    Article  CAS  PubMed  Google Scholar 

  3. Furnary AP, Zerr KJ, Grunkemeier GL, Starr A (1999) Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg 67:352–360

    Article  PubMed  Google Scholar 

  4. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE (2002) Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 87:978–982

    CAS  PubMed  Google Scholar 

  5. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in the critically ill patients. N Engl J Med 345:1359–1367

    PubMed  Google Scholar 

  6. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829

    CAS  PubMed  Google Scholar 

  7. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707–710

    Article  PubMed  Google Scholar 

  8. Moreno R, Vincent JL, Matos R, Mendonca A, Cantraine F, Thijs L, Takala J, Sprung C, Antonelli M, Bruining H, Willatts S (1999) The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis-related Problems of the ESICM. Intensive Care Med 25:686–696

    Article  PubMed  Google Scholar 

  9. Weir CJ, Murray GD, Dyker AG, Lees KR (1997) Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study. BMJ 314:1303–1306

    CAS  PubMed  Google Scholar 

  10. Woo J, Lam CW, Kay R, Wong AH, Teoh R, Nicholls MG (1990) The influence of hyperglycemia and diabetes mellitus on immediate and 3-month morbidity and mortality after acute stroke. Arch Neurol 47:1174–1177

    CAS  PubMed  Google Scholar 

  11. Gore DC, Chinkes D, Heggers J, Herndon DN, Wolf SE, Desai M (2001) Association of hyperglycemia with increased mortality after severe burn injury. J Trauma 51:540–544

    CAS  PubMed  Google Scholar 

  12. Malmberg K, Ryden L, Efendic S, Herlitz J, Nicol P, Waldenstrom A, Wedel H, Welin L (1995) Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol 26:57–65

    CAS  PubMed  Google Scholar 

  13. Capes SE, Hunt D, Malmberg K, Gerstein HC (2000) Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 355:773–778

    CAS  PubMed  Google Scholar 

  14. Saeed FA, Castle GE (1998) Neutrophil chemiluminescence during phagocytosis is inhibited by abnormally elevated levels of acetoacetate: implications for diabetic susceptibility to infections. Clin Diagn Lab Immunol 5:740–743

    CAS  PubMed  Google Scholar 

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Correspondence to Christian Christiansen.

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Christiansen, C., Toft, P., Jørgensen, H.S. et al. Hyperglycaemia and mortality in critically ill patients. Intensive Care Med 30, 1685–1688 (2004). https://doi.org/10.1007/s00134-004-2325-2

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  • DOI: https://doi.org/10.1007/s00134-004-2325-2

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