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Hyperglycaemia upon onset of ICU-acquired bloodstream infection is associated with adverse outcome in a mixed ICU population

Dominique Vandijck UGent, Sandra Oeyen UGent, Emilie Buyle, Barbara Claus UGent, Stijn Blot UGent and Johan Decruyenaere UGent (2008) ANAESTHESIA AND INTENSIVE CARE. 36(1). p.25-29
abstract
This study aimed to assess whether a relationship exists between hyperglycaemia and outcome in a mixed cohort of critically ill patients with nosocomial bloodstream infection (BSI), and to evaluate patterns of blood glucose levels between survivors and non-survivors. A historical observational cohort study was conducted in the intensive care unit (ICU) of a tertiary care referral centre. One-hundred-and-thirty patients with a microbiologically documented ICU-acquired BSI (period 2003 to 2004) were included. For the study, morning blood glucose levels were evaluated from one day prior until five days after onset of BSI. The contribution of hyperglycaemia, divided in three subgroups (>= 150 mg/dl, >= 175 mg/dl and >= 200 mg/dl), to in-hospital mortality was estimated by logistic regression. In-hospital mortality was 362%. Over the seven study days, no differences were found in daily morning blood glucose levels between survivors (n=83) and non-survivors (n=47). Nevertheless, the trend of blood glucose levels upon onset of BSI showed a remarkable increase in the non-survivors, whereas it decreased in the survivors. Hyperglycaemia (>= 175 mg/dl and >= 200 mg/dl) was observed more often among the non-survivors. Multivariate logistic regression showed that APACHE II (P=0.002), antibiotic resistance (P=0.004) and hyperglycaemia (>= 175 mg/dl) upon onset of BSI (P=0.017) were independently associated with in-hospital mortality, whereas a history of diabetes (P=0.041) was associated with better outcome. Hyperglycaemia (>= 175 mg/dl) upon onset of ICU-acquired BSI is associated with worse outcome in a heterogeneous ICU population. Patterns of morning blood glucose levels have only limited value in the prediction of the individual course.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
hyperglycaemia, nosocomial bloodstream infection, intensive care unit, hospital mortality, diabetes, CRITICALLY-ILL PATIENTS, INTENSIVE INSULIN THERAPY, CRITICAL ILLNESS, WOUND-INFECTION, MORTALITY, BACTEREMIA, SEPSIS, DEFINITIONS, MARKER
journal title
ANAESTHESIA AND INTENSIVE CARE
Anaesth. Intensive Care
volume
36
issue
1
pages
25 - 29
Web of Science type
Article
Web of Science id
000253519300005
JCR category
ANESTHESIOLOGY
JCR impact factor
0.848 (2008)
JCR rank
20/22 (2008)
JCR quartile
4 (2008)
ISSN
0310-057X
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
395642
handle
http://hdl.handle.net/1854/LU-395642
date created
2008-04-01 12:27:00
date last changed
2016-12-19 15:44:36
@article{395642,
  abstract     = {This study aimed to assess whether a relationship exists between hyperglycaemia and outcome in a mixed cohort of critically ill patients with nosocomial bloodstream infection (BSI), and to evaluate patterns of blood glucose levels between survivors and non-survivors.
A historical observational cohort study was conducted in the intensive care unit (ICU) of a tertiary care referral centre. One-hundred-and-thirty patients with a microbiologically documented ICU-acquired BSI (period 2003 to 2004) were included. For the study, morning blood glucose levels were evaluated from one day prior until five days after onset of BSI. The contribution of hyperglycaemia, divided in three subgroups ({\textrangle}= 150 mg/dl, {\textrangle}= 175 mg/dl and {\textrangle}= 200 mg/dl), to in-hospital mortality was estimated by logistic regression. In-hospital mortality was 362\%. Over the seven study days, no differences were found in daily morning blood glucose levels between survivors (n=83) and non-survivors (n=47). Nevertheless, the trend of blood glucose levels upon onset of BSI showed a remarkable increase in the non-survivors, whereas it decreased in the survivors. Hyperglycaemia ({\textrangle}= 175 mg/dl and {\textrangle}= 200 mg/dl) was observed more often among the non-survivors. Multivariate logistic regression showed that APACHE II (P=0.002), antibiotic resistance (P=0.004) and hyperglycaemia ({\textrangle}= 175 mg/dl) upon onset of BSI (P=0.017) were independently associated with in-hospital mortality, whereas a history of diabetes (P=0.041) was associated with better outcome.
Hyperglycaemia ({\textrangle}= 175 mg/dl) upon onset of ICU-acquired BSI is associated with worse outcome in a heterogeneous ICU population. Patterns of morning blood glucose levels have only limited value in the prediction of the individual course.},
  author       = {Vandijck, Dominique and Oeyen, Sandra and Buyle, Emilie and Claus, Barbara and Blot, Stijn and Decruyenaere, Johan},
  issn         = {0310-057X},
  journal      = {ANAESTHESIA AND INTENSIVE CARE},
  keyword      = {hyperglycaemia,nosocomial bloodstream infection,intensive care unit,hospital mortality,diabetes,CRITICALLY-ILL PATIENTS,INTENSIVE INSULIN THERAPY,CRITICAL ILLNESS,WOUND-INFECTION,MORTALITY,BACTEREMIA,SEPSIS,DEFINITIONS,MARKER},
  language     = {eng},
  number       = {1},
  pages        = {25--29},
  title        = {Hyperglycaemia upon onset of ICU-acquired bloodstream infection is associated with adverse outcome in a mixed ICU population},
  volume       = {36},
  year         = {2008},
}

Chicago
Vandijck, Dominique, Sandra Oeyen, Emilie Buyle, Barbara Claus, Stijn Blot, and Johan Decruyenaere. 2008. “Hyperglycaemia Upon Onset of ICU-acquired Bloodstream Infection Is Associated with Adverse Outcome in a Mixed ICU Population.” Anaesthesia and Intensive Care 36 (1): 25–29.
APA
Vandijck, D., Oeyen, S., Buyle, E., Claus, B., Blot, S., & Decruyenaere, J. (2008). Hyperglycaemia upon onset of ICU-acquired bloodstream infection is associated with adverse outcome in a mixed ICU population. ANAESTHESIA AND INTENSIVE CARE, 36(1), 25–29.
Vancouver
1.
Vandijck D, Oeyen S, Buyle E, Claus B, Blot S, Decruyenaere J. Hyperglycaemia upon onset of ICU-acquired bloodstream infection is associated with adverse outcome in a mixed ICU population. ANAESTHESIA AND INTENSIVE CARE. 2008;36(1):25–9.
MLA
Vandijck, Dominique, Sandra Oeyen, Emilie Buyle, et al. “Hyperglycaemia Upon Onset of ICU-acquired Bloodstream Infection Is Associated with Adverse Outcome in a Mixed ICU Population.” ANAESTHESIA AND INTENSIVE CARE 36.1 (2008): 25–29. Print.