title: Study of hyperglycemia in non critically-ill patients receiving parenteral nutrition: incidence and risk factors.
abstract: BACKGROUND
  The objectives of our study on non-critically ill patients receiving parenteral nutrition (PN) are to assess the incidence of hyperglycemia, the risk factors associated to its development and its influence in patient's evolution.
  
  
  METHODS
  A multicentric prospective observational study was performed in 9 hospitals. Four multivariate studies were developed to study the temporal risk in the occurrence of hyperglycemia (endpoint), intensive care unit (ICU) admission, length of stay (LOS) and death. Demographics, nutrients, drugs and clinical variables were collected. Independent variables studied as a possible risk factors were: sex, diabetes mellitus 2, baseline glycemia, albuminemia, pancreatitis, surgery in the 7 days prior to the end point, infection, insulin/somatostatin/corticoids administration during the study, glomerular filtration rate (GFR), and difference in the amount of glucose administration between the endpoint and one day before.
  
  
  RESULTS
  119 patients were enrolled in the study, 25 cases of hyperglycemia were detected. In the clinical factors associated with PN hyperglycemia, significant variables were: surgery in the 7 days before the end point, GFR, glucose load in the 24 hours previous to the end point insulin administration and somatostatine/octreotide administration during the study. Hyperglycemia was significantly associated with ICU admission and increased LOS.
  
  
  CONCLUSIONS
  Glucose administration in non-critically ill patients receiving PN should be reassessed downwards, especially in the immediate postsurgery, renal impairment and in patients treated with somatostatin analogues. It should be taken into account that an increase in glucose dose may lead to hyperglycemia in these patients and hyperglycemia correlates with longer hospital stay and increased frequency of ICU admissions.
authors.affiliation: Hospital Universitari Bellvitge-IDIBELL, Barcelona, Spain. josep.llop@bellvitgehospital.cat
authors.forename: J M
authors.initials: JM
authors.lastname: Llop
authors.forename: E
authors.initials: E
authors.lastname: Leiva
authors.forename: J
authors.initials: J
authors.lastname: Mateu-de Antonio
authors.forename: D
authors.initials: D
authors.lastname: Berlana
authors.forename: M
authors.initials: M
authors.lastname: Badia
authors.forename: T
authors.initials: T
authors.lastname: Casasín
authors.forename: M
authors.initials: M
authors.lastname: Miana
authors.forename: M
authors.initials: M
authors.lastname: Pons
authors.forename: M
authors.initials: M
authors.lastname: Maroto
authors.forename: L
authors.initials: L
authors.lastname: Chicharro
authors.forename: E
authors.initials: E
authors.lastname: López-Suñé
authors.forename: E
authors.initials: E
authors.lastname: Díaz-Munio
authors.forename: D
authors.initials: D
authors.lastname: Sevilla
authors.forename: I
authors.initials: I
authors.lastname: Martínez
authors.forename: M
authors.initials: M
authors.lastname: Vitales
authors.forename: M T
authors.initials: MT
authors.lastname: Casajuana
authors.forename: M A
authors.initials: MA
authors.lastname: Bobis
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003422:Critical Care; D016638:Critical Illness; D023381:Endpoint Determination; D005260:Female; D005919:Glomerular Filtration Rate; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012307:Risk Factors; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D013004:Somatostatin; D005947:Glucose