Abstract
BACKGROUND Hyperglycemia during hospital stay is associated with adverse outcomes. AIM To characterize the frequency of hyperglycemia in a tertiary hospital and to correlate it with length of hospital stay (LOS). MATERIAL AND METHODS Review of medical records of hospitalized patients. Demographic data and laboratory data, previous diabetes mellitus (DM) history, current main diagnosis, unit of hospitalization and the two highest capillary blood glucose values from the analyzed period were recorded for each patient. LOS was obtained from electronic clinical records. RESULTS 210 subjects, aged 60 ± 19 years (104 women) were included. 113 patients (54%) developed hyperglycemia ≥ 140 mg/L. Thirty one percent of these had a previous history of diabetes and 29% had stress hyperglycemia (SHG). Patients with a history of DM had a higher average blood glucose than those with SHG (238.9 and 178.2 mg/dL, respectively, p < 0.01) and a greater percentage of cases with a blood glucose above 180 mg/dL (72 and 40.0%, respectively, p < 0.01). Hospital LOS was significantly longer in patients with hyperglycemia ≥ 140 mg/dL as compared with those with normoglycemia (29.3 and 12.8 days, respectively, p < 0.01). This association remained significant when introduced in a linear regression analysis including diagnosis, decreased glomerular filtration rate (GFR) and hospitalization unit (p < 0.01). CONCLUSIONS Hyperglycemia during hospitalization affects more than half of hospitalized patients and is associated with a longer length of stay.
Highlights
Demographic data and laboratory data, previous diabetes mellitus (DM) history, current main diagnosis, unit of hospitalization and the two highest capillary blood glucose values from the analyzed period were recorded for each patient
Hospital length of hospital stay (LOS) was significantly longer in patients with hyperglycemia ≥ 140 mg/dL as compared with those with normoglycemia (29.3 and 12.8 days, respectively, p < 0.01). This association remained significant when introduced in a linear regression analysis including diagnosis, decreased glomerular filtration rate (GFR) and hospitalization unit (p < 0.01)
Aproximadamente la mitad de los casos de hiperglicemia en el hospital ocurre en pacientes sin antecedentes de DM, y se explicarían por las hormonas contrarreguladoras secretadas en relación al estrés derivado de enfermedades causales de la hospitalización, las que, además, pueden tener terapias complejas que generen efectos metabólicos no deseados[1,3]
Summary
Hospital LOS was significantly longer in patients with hyperglycemia ≥ 140 mg/dL as compared with those with normoglycemia (29.3 and 12.8 days, respectively, p < 0.01). This association remained significant when introduced in a linear regression analysis including diagnosis, decreased glomerular filtration rate (GFR) and hospitalization unit (p < 0.01). En consecuencia con lo expuesto, guías clínicas internacionales definen una glicemia mayor a 140 mg/dL como “hiperglicemia” en contexto hospitalario, recomendando una meta deseada para el control glicémico de 140 a 180 mg/dL y con indicación de tratamiento con insulina en todo paciente con hiperglicemia > 180 mg/dL. Se detallaron variables asociadas a la presencia de hiperglicemia, ya sea de la patología de ingreso del paciente, o del servicio en el que se encuentran hospitalizados y su relación con el tiempo de estadía hospitalaria
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