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Critical Care

, 11:P128 | Cite as

Hyperglycemia upon onset of nosocomial bloodstream infection adversely affects outcome in a mixed intensive care unit population

  • D Vandijck
  • S Oeyen
  • F Buyle
  • B Claus
  • S Blot
  • J Decruyenaere
Poster presentation
  • 884 Downloads

Keywords

Hyperglycemia Blood Glucose Level Antibiotic Resistance Antimicrobial Therapy Observational Cohort Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Hyperglycemia in critically ill patients is frequently related to a hypermetabolic stress-response and has been associated with increased morbidity and mortality. The aim of this study was to assess the relationship between blood glucose levels and clinical outcome in a mixed cohort of critically ill patients with a nosocomial bloodstream infection (BSI).

Methods

A retrospective observational cohort study was conducted including 130 adult patients with a microbiologically documented BSI admitted over a 2-year period (2003–2004) to the ICU. Blood glucose levels were evaluated from 1 day prior to onset of BSI (d-1) until 5 days after onset of BSI (d+5). The contribution of hyperglycemia, divided into three subgroups (≥150 mg/dl, ≥175 mg/dl, and ≥200 mg/dl, respectively), to inhospital mortality was estimated by logistic regression.

Results

The mean age of the study population was 54.7 ± 19.0 years. Inhospital mortality was 36.2%. Hyperglycemia (≥175 mg/dl and ≥200 mg/dl) was observed more often among the non-survivors. Over the seven study days, no differences were found in daily morning blood glucose levels between survivors (n = 83) and nonsurvivors (n = 47) (all P > 0.05). Although in the nonsurvivors the evolution of glycemia tended to be higher, this trend was not statistically significant compared with the survivors. Multivariate logistic regression revealed that age (P = 0.022), APACHE II score (P = 0.003), antibiotic resistance (P = 0.001), and hyperglycemia (≥ 200 mg/dl) upon onset of BSI (P = 0.001) were independently associated with inhospital mortality, whereas appropriate antimicrobial therapy ≤24 hours (P = 0.016) and previous history of diabetes (P = 0.022) were associated with better outcome.

Conclusion

Trends of blood glucose levels were higher among nonsurvivors. Hyperglycemia (≥200 mg/dl) upon onset of nosocomial BSI adversely affects outcome in a heterogeneous ICU population.

Copyright information

© BioMed Central Ltd. 2007

Authors and Affiliations

  • D Vandijck
    • 1
  • S Oeyen
    • 1
  • F Buyle
    • 1
  • B Claus
    • 1
  • S Blot
    • 1
  • J Decruyenaere
    • 1
  1. 1.Ghent University HospitalGhentBelgium

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