title: Stress hyperglycemia may not be harmful in critically ill patients with sepsis.
abstract: BACKGROUND
  Stress hyperglycemia (SH) is commonly seen in critically ill patients. It has been shown to be associated with adverse outcomes in some groups of patients. The effects of SH on critically ill patients with sepsis have not been well studied. We aimed to evaluate the effects of SH in critically ill patients with sepsis.
  
  
  METHODS
  In this retrospective study, patients with sepsis admitted to intensive care unit (ICU) over a 5-year period were included.
  
  
  RESULTS
  Of 297 patients, 204 (68.7%) had SH during the study period. The mean blood glucose level in patients with SH was 8.7 mmol/L compared with 5.9 mmol/L in those without SH (P < .05). There were no statistically significant differences in age; sex; sepsis severity; cardiovascular, respiratory, and renal comorbidities; requirement of mechanical ventilation; inotropes; and Acute Physiology, Age, and Chronic Health Evaluation III and Simplified Acute Physiology 2 scores on ICU admission. Intensive care unit mortality was significantly lower in patients who had SH. The median duration of ICU and hospital length of stay was longer in patients with SH. On logistic regression analysis, the presence of SH was associated with reduced ICU mortality. Subgroup analysis revealed SH to be protective in patients with septic shock.
  
  
  CONCLUSIONS
  Stress hyperglycemia may not be harmful in critically ill patients with sepsis. Patients with SH had lower ICU mortality.
authors.affiliation: Department of Intensive Care Medicine, Frankston Hospital, Frankston, VIC 3199, Australia. travindranath@hotmail.com
authors.forename: Ravindranath
authors.initials: R
authors.lastname: Tiruvoipati
authors.forename: Belchi
authors.initials: B
authors.lastname: Chiezey
authors.forename: David
authors.initials: D
authors.lastname: Lewis
authors.forename: Kevin
authors.initials: K
authors.lastname: Ong
authors.forename: Elmer
authors.initials: E
authors.lastname: Villanueva
authors.forename: Kavi
authors.initials: K
authors.lastname: Haji
authors.forename: John
authors.initials: J
authors.lastname: Botha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000401:mortality; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D013312:Stress, Physiological; D016896:Treatment Outcome