000			03452nam a22003137a 4500
001			CUHAS/MMED/6000200/T/16
003			CUHAS/MMED/6000200/T/16
005			20240418154140.0
008			210821b |||||||| |||| 00| 0 eng d
028			_bWurzburg Road 35, BMC Premises, Post Code: 33102:
028			_b P. O Box 1464, Mwanza – Tanzania:
028			_bPhone: +255 28 298 3384:
028			_bFax: +255 28 298 3386:
028			_bEmail: vc@bugando.ac.tz :
028			_bwww.bugando.ac.tz
035			_aCUHAS/MMED/6000200/T/16
040			_cddc
041			_aEnglish
100			_a Deodatus Mabula _d[Male] _922759 _eCUHAS/MMED/6000200/T/16
245			_aPrevalence, Associated Factors and Outcomes of Admission Stress Hyperglycemia Among Critically Ill Medical Patients Admitted at Bugando Medical Centre.
260			_aMwanza, Tanzania: _b Catholic University of Health and Allied Sciences [CUHAS - Bugando] : _c2019
300			_a xv; 61 Pages
300			_aIncludes Index
520			_aAbstract: 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.
600			_xInternal Medicine _915587
700			_aSamuel Kalluvya _922760
700			_aFredrick Kalokola _922761
942			_2ddc _cMP
999			_c18467 _d18467