title: Stress-induced hyperglycemia in patients with severe sepsis: a compromising factor for survival.
abstract: OBJECTIVE
  To study the clinical and laboratory characteristics of patients with severe sepsis and baseline hyperglycemia and investigate the impact of hyperglycemia on the final outcome.
  
  
  METHODS
  A total of 265 patients admitted with severe sepsis in 3 major hospitals in South-Western Greece, during a 1-year period, were included in the study. Patients were divided in 3 groups according to their glycemic profile at admission: patients with stress hyperglycemia (group SH, n=47), with diabetes mellitus (group DM, n=65), and with normal glucose level (group NG, n=153). Hyperglycemia was defined as an admission or in-hospital fasting glucose level of >or=126 mg/dL or a random blood glucose level of >or=200 mg/dL on >or=2 determinations.
  
  
  RESULTS
  A total of 42.2% of patients with severe sepsis had baseline hyperglycemia with 17.7% having sepsis-induced stress hyperglycemia. No family history was noted in the SH group. A higher percentage of septic patients with stress hyperglycemia died compared with patients with normal glucose levels (42.5% versus 13.7%) and diabetics (42.5% versus 24.6%). Group DM had also a poorer prognosis than group NG (24.6% versus 13.7%). A positive correlation was detected between the fasting blood glucose levels of group SH and the severity of sepsis indicated by sepsis-related organ failure assessment score.
  
  
  CONCLUSIONS
  Baseline hyperglycemia, including stress-induced hyperglycemia, is common in patients with severe sepsis. Stress-induced hyperglycemia is related to a more severe disease and poorer prognosis.
authors.affiliation: Department of Internal Medicine, Patras University Hospital, Rion-Patras, Greece.
authors.forename: Leonidia
authors.initials: L
authors.lastname: Leonidou
authors.forename: Marina
authors.initials: M
authors.lastname: Michalaki
authors.forename: Ageliki
authors.initials: A
authors.lastname: Leonardou
authors.forename: Eftihia
authors.initials: E
authors.lastname: Polyzogopoulou
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Fouka
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Gerolymos
authors.forename: Pantelis
authors.initials: P
authors.lastname: Leonardos
authors.forename: Agathoklis
authors.initials: A
authors.lastname: Psirogiannis
authors.forename: Venetsana
authors.initials: V
authors.lastname: Kyriazopoulou
authors.forename: Charalambos A
authors.initials: CA
authors.lastname: Gogos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000503:physiopathology*; D013312:Stress, Physiological; D015996:Survival Rate