title: Parenteral nutrition-associated hyperglycemia in non-critically ill inpatients increases the risk of in-hospital mortality (multicenter study).
abstract: OBJECTIVE
  Hyperglycemia may increase mortality in patients who receive total parenteral nutrition (TPN). However, this has not been well studied in noncritically ill patients (i.e., patients in the nonintensive care unit setting). The aim of this study was to determine whether mean blood glucose level during TPN infusion is associated with increased mortality in noncritically ill hospitalized patients.
  
  
  METHODS
  This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included prospectively, and data were collected on demographic, clinical, and laboratory variables as well as on in-hospital mortality.
  
  
  RESULTS
  The study included 605 patients (mean age 63.2 ± 15.7 years). The daily mean TPN values were 1.630 ± 323 kcal, 3.2 ± 0.7 g carbohydrates/kg, 1.26 ± 0.3 g amino acids/kg, and 0.9 ± 0.2 g lipids/kg. Multiple logistic regression analysis showed that the patients who had mean blood glucose levels >180 mg/dL during the TPN infusion had a risk of mortality that was 5.6 times greater than those with mean blood glucose levels <140 mg/dL (95% CI 1.47-21.4 mg/dL) after adjusting for age, sex, nutritional state, presence of diabetes or hyperglycemia before starting TPN, diagnosis, prior comorbidity, carbohydrates infused, use of steroid therapy, SD of blood glucose level, insulin units supplied, infectious complications, albumin, C-reactive protein, and HbA1c levels.
  
  
  CONCLUSIONS
  Hyperglycemia (mean blood glucose level >180 mg/dL) in noncritically ill patients who receive TPN is associated with a higher risk of in-hospital mortality.
authors.affiliation: Carlos Haya University Hospital, Malaga, Spain. gabrielm.olveira.sspa@juntadeandalucia.es
authors.forename: Gabriel
authors.initials: G
authors.lastname: Olveira
authors.forename: María José
authors.initials: MJ
authors.lastname: Tapia
authors.forename: Julia
authors.initials: J
authors.lastname: Ocón
authors.forename: Carmen
authors.initials: C
authors.lastname: Cabrejas-Gómez
authors.forename: María D
authors.initials: MD
authors.lastname: Ballesteros-Pomar
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vidal-Casariego
authors.forename: Carmen
authors.initials: C
authors.lastname: Arraiza-Irigoyen
authors.forename: Josefina
authors.initials: J
authors.lastname: Olivares
authors.forename: Maria Del Carmen
authors.initials: Mdel C
authors.lastname: Conde-García
authors.forename: Alvaro
authors.initials: A
authors.lastname: García-Manzanares
authors.forename: Francisco
authors.initials: F
authors.lastname: Botella-Romero
authors.forename: Rosa P
authors.initials: RP
authors.lastname: Quílez-Toboso
authors.forename: Lucio
authors.initials: L
authors.lastname: Cabrerizo
authors.forename: Pilar
authors.initials: P
authors.lastname: Matia
authors.forename: Luisa
authors.initials: L
authors.lastname: Chicharro
authors.forename: Rosa
authors.initials: R
authors.lastname: Burgos
authors.forename: Pedro
authors.initials: P
authors.lastname: Pujante
authors.forename: Mercedes
authors.initials: M
authors.lastname: Ferrer
authors.forename: Ana
authors.initials: A
authors.lastname: Zugasti
authors.forename: Javier
authors.initials: J
authors.lastname: Prieto
authors.forename: Marta
authors.initials: M
authors.lastname: Diéguez
authors.forename: María José
authors.initials: MJ
authors.lastname: Carrera
authors.forename: Anna
authors.initials: A
authors.lastname: Vila-Bundo
authors.forename: Juan Ramón
authors.initials: JR
authors.lastname: Urgelés
authors.forename: Carmen
authors.initials: C
authors.lastname: Aragón-Valera
authors.forename: Adela
authors.initials: A
authors.lastname: Rovira
authors.forename: Irene
authors.initials: I
authors.lastname: Bretón
authors.forename: Pilar
authors.initials: P
authors.lastname: García-Peris
authors.forename: Araceli
authors.initials: A
authors.lastname: Muñoz-Garach
authors.forename: Efren
authors.initials: E
authors.lastname: Márquez
authors.forename: Dolores
authors.initials: D
authors.lastname: Del Olmo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Pereira
authors.forename: María C
authors.initials: MC
authors.lastname: Tous
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011446:Prospective Studies