Hyperglycaemia and mortality of diabetic patients with candidaemia.
OBJECTIVE
To determine whether the degree of hyperglycaemia has an impact on in-hospital mortality in diabetic patients with candidaemia.


METHODS
A retrospective cohort study of 87 diabetic patients with candidaemia admitted between June 1995 and June 2003 was carried out at two medical centres. Patients were stratified into two groups: those with moderate hyperglycaemia (7 days post-candidaemia mean blood glucose < 13.9 mmol/l) and those with severe hyperglycaemia (7 days post-candidaemia mean blood glucose > or = 13.9 mmol/l). A stepwise logistic regression analysis was performed to determine whether the degree of hyperglycaemia was a significant predictor of mortality.


RESULTS
During the follow-up period from admission till discharge, 34 (39.1%) patients had died. Nine (69.2%) of 13 patients with severe hyperglycaemia have died while 25 (33.8%) of 74 patients with moderate hyperglycaemia have died. Multivariate analysis identified three independent determinants of death; Apache II score > or = 23 [OR 8.1, 95% CI (2.6, 25.3), P = 0.0003], mean blood glucose levels 7 days post-candidaemia > or = 13.9 mmol/l [OR 6.8, 95% CI (1.2, 38.2), P = 0.03], and mechanical ventilation [OR 6.5, 95% CI (2.21), P = 0.03].


CONCLUSIONS
Severe hyperglycaemia is an important marker of increased mortality among hospitalized diabetic patients with candidaemia.
Bader
M S
MS
Division of Infectious Diseases, Department of Preventive Medicine, University of Kansas Medical Center, KS, USA. msbader1@hotmail.com
Hinthorn
D
D
Lai
S M
SM
Ellerbeck
E F
EF
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000097:blood / Q000150:complications / Q000401:mortality*; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D001786:Blood Glucose