open access

Vol 50, No 1 (2018)
Original and clinical articles
Published online: 2018-03-31
Submitted: 2017-07-12
Accepted: 2018-02-01
Get Citation

The impact of the blood glucose levels of non-diabetic critically ill patients on their clinical outcome

Leonid Koyfman, Evgeni Brotfain, Alexander Erblat, Inna Kovalenko, Yair-Yaish Reina, Yoav Bichovsky, Abraham Borer, Michael Friger, Amit Frenkel, Moti Klein
DOI: 10.5603/AIT.2018.0004
·
Pubmed: 29637989
·
Anaesthesiol Intensive Ther 2018;50(1):20-26.

open access

Vol 50, No 1 (2018)
Original and clinical articles
Published online: 2018-03-31
Submitted: 2017-07-12
Accepted: 2018-02-01

Abstract

Background: Stress hyperglycaemia is thought to result from a hormonal response (release of catecholamines,
glucocorticoids, glucagon, etc.) following stress, sepsis or trauma. Although stress hyperglycaemia is a very common
finding in critically ill populations, there are many non-diabetic critically ill patients who do not develop a hyperglycaemic
stress response to trauma or acute illness. We suggest that the lack of a hyperglycaemic stress response
during the acute phase of a critical illness may correlate significantly with the clinical outcome of these critically ill
non-diabetic patients.

Methods: This was a retrospective study of 700 non-diabetic critically ill patients admitted to the general intensive
care unit (ICU) at Soroka Medical Center, Beer Sheva, Israel. We analyzed the clinical impact of the blood glucose levels
of these patients measured during their first week of ICU hospitalization on their clinical outcome.


Results: Age, male gender, and the Acute Physiology and Chronic Health Evaluation (APACHE) score were found to
be independent risk factors for new episodes of infection during the patients’ stay in the ICU. Age and the APACHE
and Sequential Organ Failure Assessment scores were found to be independent risk factors for intra-ICU mortality. In
contrast, blood glucose analysis performed during the patients’ stay in the ICU was not found to be an independent
predictor for new infectious events or for mortality during the ICU stay.

Conclusion: Our study did not demonstrate an association between blood glucose levels and clinical outcomes in
non-diabetic critically ill patients.

Abstract

Background: Stress hyperglycaemia is thought to result from a hormonal response (release of catecholamines,
glucocorticoids, glucagon, etc.) following stress, sepsis or trauma. Although stress hyperglycaemia is a very common
finding in critically ill populations, there are many non-diabetic critically ill patients who do not develop a hyperglycaemic
stress response to trauma or acute illness. We suggest that the lack of a hyperglycaemic stress response
during the acute phase of a critical illness may correlate significantly with the clinical outcome of these critically ill
non-diabetic patients.

Methods: This was a retrospective study of 700 non-diabetic critically ill patients admitted to the general intensive
care unit (ICU) at Soroka Medical Center, Beer Sheva, Israel. We analyzed the clinical impact of the blood glucose levels
of these patients measured during their first week of ICU hospitalization on their clinical outcome.


Results: Age, male gender, and the Acute Physiology and Chronic Health Evaluation (APACHE) score were found to
be independent risk factors for new episodes of infection during the patients’ stay in the ICU. Age and the APACHE
and Sequential Organ Failure Assessment scores were found to be independent risk factors for intra-ICU mortality. In
contrast, blood glucose analysis performed during the patients’ stay in the ICU was not found to be an independent
predictor for new infectious events or for mortality during the ICU stay.

Conclusion: Our study did not demonstrate an association between blood glucose levels and clinical outcomes in
non-diabetic critically ill patients.

Get Citation

Keywords

glycaemia, hypoglycaemia, hyperglycaemia; critical illness; non-diabetic critically ill patients

About this article
Title

The impact of the blood glucose levels of non-diabetic critically ill patients on their clinical outcome

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 50, No 1 (2018)

Pages

20-26

Published online

2018-03-31

DOI

10.5603/AIT.2018.0004

Pubmed

29637989

Bibliographic record

Anaesthesiol Intensive Ther 2018;50(1):20-26.

Keywords

glycaemia
hypoglycaemia
hyperglycaemia
critical illness
non-diabetic critically ill patients

Authors

Leonid Koyfman
Evgeni Brotfain
Alexander Erblat
Inna Kovalenko
Yair-Yaish Reina
Yoav Bichovsky
Abraham Borer
Michael Friger
Amit Frenkel
Moti Klein

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