Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients.
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.
Pasquel
Francisco J
FJ
Department ofMedicine, Emory University School ofMedicine, Atlanta, Georgia, USA.
Spiegelman
Ronnie
R
McCauley
Megan
M
Smiley
Dawn
D
Umpierrez
Denise
D
Johnson
Rachel
R
Rhee
Mary
M
Gatcliffe
Chelsea
C
Lin
Erica
E
Umpierrez
Erica
E
Peng
Limin
L
Umpierrez
Guillermo E
GE
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
D001786:Blood Glucose