Title: Hyperglycemia in critically ill patients and its association with increased mortality. A hospital based observational study

Abstract

Objective: Hyperglycemia is an independent risk factor in critically ill patients, contributing to increased mortality and morbidity. This study was conducted to see the adverse effects of hyperglycemia in the form of increased mortality in medical ICU patients. This Stress induced hyperglycemia is a well known entity and has been found to be associated with adverse outcome in various studies conducted worldwide but the data in India especially in the remote north eastern part is lacking. This will help to predict the prognosis and timely intervention. Methods: This descriptive observational study was carried out amongst patients admitted in medical intensive care unit in a tertiary care hospital in Sikkim. Medical records of the patients between July 2015 to December 2015 were reviewed. Patients with admission hyperglycemia (>140 mg %) were chosen for the study irrespective of previous history of diabetes mellitus. Outcome in the form of discharge or death was noted. After fulfilling the inclusion criteria, 160 patients were selected. Chi square test was used to analyze the quantitative data at p<0.05 and CI-95%. Results are presented using percentage. Results: Patients with admission hyperglycemia (>140 mg %) had significantly higher mortality as compared to patients with normal blood glucose level (p-0.0063, CI-1.347 - 4.936, OR-2.5) This relationship existed both in diabetics as well as new onset hyperglycemics. Conclusion: In hospital, hyperglycemia is an independent predictor of mortality in critically ill patients.