Admission Hyperglycemia Aggravates the Prognosis of Critically Ill Patients

Lee, Jong Seok; Chang, Chul Ho; Shim, Yon Hee; Han, Dong Woo; Kim, Chang Seok; Shin, Cheung Soo

Abstract

BACKGROUND
Hyperglycemia is a common disease in critically ill patients, even those without diabetes. It has been recognized acute increase of blood glucose level would increase mortality in patients with and without diabetes in vascular disease such as acute myocardial infarct or acute stroke. However, there is not much data about hyperglycemic effects on the prognosis of patients with heterogenous disease in general intensive care unit (ICU). Aim of this study was to evaluate the effects of admission hyperglycemia on prognosis of critically ill patients with heterogenous disease. METHODS: We reviewed medical records of 712 patients admitted general ICU from July, 2000 to March, 2002 in teaching hospital. The patients who were not checked blood glucose level at ICU admission were excluded. We regarded diabetes patients who have been diagnosed diabetes before ICU admission. Hyperglycemia was defined as a fasting glucose level above 140 mg/dl or random glucose level above 200 mg/dl on 2 or more determinations. We measured hospital mortality, ICU stay, and hospital stay as well as blood glucose level. RESULT: Patients mortalities of diabetic hypergylcemia, nondiabetic hyperglycemia, diabetic normoglycemia, and nondiabetic normoglycemia were 17%, 19%, 26% and 10% respectively. CONCLUSIONS: Mortality of diabetic patients regardless of hyperglycemia at admission time and nondiabetic hyperglycemia patients were higher than nondiabetic normoglycemia patients in ICU.