Prevalence, Associated Factors and Outcomes of Admission Stress Hyperglycemia Among Critically Ill Medical Patients Admitted at Bugando Medical Centre.
Deodatus Mabula [Male]
Prevalence, Associated Factors and Outcomes of Admission Stress Hyperglycemia Among Critically Ill Medical Patients Admitted at Bugando Medical Centre. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2019 - xv; 61 Pages Includes Index
Abstract:
Background: Stress hyperglycemia has been the commonly encountered problem in critically ill medical patients with negative impacts both on disease severity, hospital stay and mortality and this has been seen mostly in patients with no prior history of diabetes mellitus. Despite the burden of these abnormalities, we have the scarcity of data on its prevalence, associated factors in critically ill patients in our setting and in Africa at all.
Objectives: To assess the prevalence, associated factors and outcomes of stress hyperglycemia among critically ill medical patients admitted at BMC.
Methodology: This is a cross-sectional study with a follow up component done at Bugando Medical Centre. It included all medical critically ill adult patients while excluding those who are known to be Diabetic patients or on medications for Diabetes Mellitus. Admission blood glucose was taken to every patient and those with RBG> 7.8 glycated hemoglobin was measured. We documented the in-hospital outcome, duration of hospital stay and 90-days follow up from discharge for all-cause mortality.
Results: The overall prevalence in this study was 19.1% (n=284) where by stroke (42.6%) and heart failure (37%) were the leading contributors. A history of heart failure OR=81.4 [95% CI 13.4-494.5] P 0.001 and stroke OR=5.9 [95% CI 2.4-14.1] P-<0.001 were associated with stress hyperglycemia and this was also seen with being obese in males OR=4.5 [95% CI 1.1-18.7] P-0.04 and having altered mental status OR=9.1 [95% CI 1.5-53.6] P-0.014. There was also an association between stress hyperglycemia and being diagnosed to have stroke OR=3.7 [95% CI 1.2-12] P-0.03 and heart failure OR=6.6 [95% CI 2-21.8] P-0.002. Stress hyperglycemia was associated with increased in-hospital mortality OR=30.3 [95% CI 7.3-126.7] P-<0.001 and more than 10 days hospital stay OR=12.3 [95% CI 3.4-44.7] P- <0.001 but there was no association with 90 day outcomes OR=1.6 [CI 0.34-6.7] P-0.557.
Conclusion: Stress hyperglycemia is common among critically ill medical patients and is associated with poor outcomes. Admission random glucose may be used as a prognostic factor, especially in stroke and heart failure patients in both predicting the hospital stay and in-hospital mortality.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Internal Medicine
Prevalence, Associated Factors and Outcomes of Admission Stress Hyperglycemia Among Critically Ill Medical Patients Admitted at Bugando Medical Centre. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2019 - xv; 61 Pages Includes Index
Abstract:
Background: Stress hyperglycemia has been the commonly encountered problem in critically ill medical patients with negative impacts both on disease severity, hospital stay and mortality and this has been seen mostly in patients with no prior history of diabetes mellitus. Despite the burden of these abnormalities, we have the scarcity of data on its prevalence, associated factors in critically ill patients in our setting and in Africa at all.
Objectives: To assess the prevalence, associated factors and outcomes of stress hyperglycemia among critically ill medical patients admitted at BMC.
Methodology: This is a cross-sectional study with a follow up component done at Bugando Medical Centre. It included all medical critically ill adult patients while excluding those who are known to be Diabetic patients or on medications for Diabetes Mellitus. Admission blood glucose was taken to every patient and those with RBG> 7.8 glycated hemoglobin was measured. We documented the in-hospital outcome, duration of hospital stay and 90-days follow up from discharge for all-cause mortality.
Results: The overall prevalence in this study was 19.1% (n=284) where by stroke (42.6%) and heart failure (37%) were the leading contributors. A history of heart failure OR=81.4 [95% CI 13.4-494.5] P 0.001 and stroke OR=5.9 [95% CI 2.4-14.1] P-<0.001 were associated with stress hyperglycemia and this was also seen with being obese in males OR=4.5 [95% CI 1.1-18.7] P-0.04 and having altered mental status OR=9.1 [95% CI 1.5-53.6] P-0.014. There was also an association between stress hyperglycemia and being diagnosed to have stroke OR=3.7 [95% CI 1.2-12] P-0.03 and heart failure OR=6.6 [95% CI 2-21.8] P-0.002. Stress hyperglycemia was associated with increased in-hospital mortality OR=30.3 [95% CI 7.3-126.7] P-<0.001 and more than 10 days hospital stay OR=12.3 [95% CI 3.4-44.7] P- <0.001 but there was no association with 90 day outcomes OR=1.6 [CI 0.34-6.7] P-0.557.
Conclusion: Stress hyperglycemia is common among critically ill medical patients and is associated with poor outcomes. Admission random glucose may be used as a prognostic factor, especially in stroke and heart failure patients in both predicting the hospital stay and in-hospital mortality.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Internal Medicine