Diabetes care · 2009
Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Pasquel Francisco J, Spiegelman Ronnie, McCauley Megan, Smiley Dawn, Umpierrez Denise, Johnson Rachel, Rhee Mary, Gatcliffe Chelsea, Lin Erica, Umpierrez Erica, Peng Limin, Umpierrez Guillermo E
Аннотация
OBJECTIVE: To determine the effect of total parenteral nutrition (TPN)-induced hyperglycemia on hospital outcome.
RESEARCH DESIGN AND METHODS: The study determined whether blood glucose values before, within 24 h, and during days 2-10 of TPN are predictive of hospital complications and mortality.
RESULTS: Subjects included a total of 276 patients receiving TPN for a mean duration of 15 +/- 24 days (+/-SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121-150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1-4.4, P = 0.030), 151-180 mg/dl (3.41, 1.3-8.7, P = 0.01), and >180 mg/dl (2.2, 0.9-5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2-6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4-7.1) and acute renal failure (2.3, 1.1-5.0).
CONCLUSIONS: Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN.
RESEARCH DESIGN AND METHODS: The study determined whether blood glucose values before, within 24 h, and during days 2-10 of TPN are predictive of hospital complications and mortality.
RESULTS: Subjects included a total of 276 patients receiving TPN for a mean duration of 15 +/- 24 days (+/-SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121-150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1-4.4, P = 0.030), 151-180 mg/dl (3.41, 1.3-8.7, P = 0.01), and >180 mg/dl (2.2, 0.9-5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2-6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4-7.1) and acute renal failure (2.3, 1.1-5.0).
CONCLUSIONS: Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN.