title: 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.
  
  
  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.
authors.affiliation: Department ofMedicine, Emory University School ofMedicine, Atlanta, Georgia, USA.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Pasquel
authors.forename: Ronnie
authors.initials: R
authors.lastname: Spiegelman
authors.forename: Megan
authors.initials: M
authors.lastname: McCauley
authors.forename: Dawn
authors.initials: D
authors.lastname: Smiley
authors.forename: Denise
authors.initials: D
authors.lastname: Umpierrez
authors.forename: Rachel
authors.initials: R
authors.lastname: Johnson
authors.forename: Mary
authors.initials: M
authors.lastname: Rhee
authors.forename: Chelsea
authors.initials: C
authors.lastname: Gatcliffe
authors.forename: Erica
authors.initials: E
authors.lastname: Lin
authors.forename: Erica
authors.initials: E
authors.lastname: Umpierrez
authors.forename: Limin
authors.initials: L
authors.lastname: Peng
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose