Stress Hyperglycemia Incidence in Critically Ill Patients: Cross- Sectional Observational Study
1Department of Internal Medicine, Division of Intesive Care, Erciyes University School of Medicine, Kayseri, Turkey
2Department of Anesthesiology and Reanimation, Division of Intesive Care, Erciyes University School of Medicine, Kayseri, Turkey
J Crit Intensive Care 2018; 9(2): 46-50 DOI: 10.5152/dcbybd.2018.1602
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Abstract

Objective: Stress hyperglycemia is a common condition in intensive care units. It is associated with poor prognosis and mortality. We aimed to determine the frequency of stress hyperglycemia and its relation to morbidity and mortality in intensive care units.
Material and Methods: This study was prospectively conducted at the medical and anesthesiology intensive care unit. Patients ≥18 years of age who stayed in this intensive care unit for 48 hours or more were included in this study.
Results: In total, 50 patients were included in the study. The mean age of the patients was 42.8±18.8 years. The most common cause of admission to the intensive care unit was trauma (56%). Laboratory blood glucose level of the patients on the first day of study was 129.9±51.0 mg/dL. The HbA1c value was 4.98±0.46 on the day of admission to the intensive care unit. On the first day of the study, laboratory blood sugar was found to be ≥140 mg/dL in 14 patients (28%). The number of patients with stress hyperglycemia during a one-week period was 32 (64%). During the time patients were in the intensive care unit, the development of new infection occurred in 19 patients (38%). The median duration of stay in the intensive care unit was 7.5 (range, 3-78) days, and the median duration of stay in the hospital was 13 (range, 3-101) days. The rate of new infection development was higher in patients with stress hyperglycemia (50%) than in those without (26.0%) (p=0.02). The duration of stay in the intensive care unit was found to be higher in patients with stress hyperglycemia (median, 9.5 days; range, 3-78 days) than in those without (median, 5 days; range, 3–31 days) (p=0.012). The duration of stay in hospital was found to be higher in patients with stress hyperglycemia (median, 14 days; range, 3-101 days) than in those without (median, 11 days; range, 3-50 days) (p=0.07). The total rate of mortality in the intensive care unit was 20%. Intensive care mortality was 20% in all patients. The rate of mortality in the intensive care unit was higher in patients with stress hyperglycemia (28.1%) than in those without (5.6%) (p=0.05).
Conclusion: Stress hyperglycemia was found to be high in critically ill patients. Mortality and new infection rates were higher in patients with stress hyperglycemia.