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Author Notes:
Corresponding author: Guillermo Umpierrez, Email: geumpie@emory.edu
We appreciate the support of the Medical Records Department staff at Grady Memorial Hospital. This work was presented in abstract form at the 69th Scientific Sessions, American Diabetes Association, New Orleans, Louisiana, 5–9 June 2009.
No potential conflicts of interest relevant to this article were reported.
Subjects:
Research Funding:
G.E.U. is supported by research grants from the American Diabetes Association (7-03-CR-35) and the National Institutes of Health (M01 RR-00039).
Hyperglycemia During Total Parenteral Nutrition An important marker of poor outcome and mortality in hospitalized patients
Abstract:
OBJECTIVE
To determine the effect of total parenteral nutrition (TPN)-induced hyperglycemia on hospital outcome.
RESEARCH DESIGN AND METHODS
The study determined whether blood glucose values before, within 24 h, and during days 2–10 of TPN are predictive of hospital complications and mortality.
RESULTS
Subjects included a total of 276 patients receiving TPN for a mean duration of 15 ± 24 days (±SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121–150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1–4.4, P = 0.030), 151–180 mg/dl (3.41, 1.3–8.7, P = 0.01), and >180 mg/dl (2.2, 0.9–5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2–6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4–7.1) and acute renal failure (2.3, 1.1–5.0).
CONCLUSIONS
Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN.
Copyright information:
© 2010 by the American Diabetes Association
This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).
