Prevalencia de hiperglicemia y su relación con el tiempo de estadía en un hospital terciario

Abstract

Association of hyperglycemia with the length of stay in hospitalized patientsBackground: Hyperglycemia during hospital stay is associated with adverse outcomes. Aim: To characterize the frequency of hyperglycemia in a tertiary hospital and to correlate it with length of hospital stay (LOS). Material and Methods: Review of medical records of hospitalized patients. Demographic data and laboratory data, previous diabetes mellitus (DM) history, current main diagnosis, unit of hospitalization and the two highest capillary blood glucose values from the analyzed period were recorded for each patient. LOS was obtained from electronic clinical records. Results: 210 subjects, aged 60 ± 19 years (104 women) were included. 113 patients (54%) developed hyperglycemia ≥ 140 mg/L. Thirty one percent of these had a previous history of diabetes and 29% had stress hyperglycemia (SHG). Patients with a history of DM had a higher average blood glucose than those with SHG (238.9 and 178.2 mg/dL, respectively, p < 0.01) and a greater percentage of cases with a blood glucose above 180 mg/dL (72 and 40.0%, respectively, p < 0.01). Hospital LOS was significantly longer in patients with hyperglycemia ≥ 140 mg/dL as compared with those with normoglycemia (29.3 and 12.8 days, respectively, p < 0.01). This association remained significant when introduced in a linear regression analysis including diagnosis, decreased glomerular filtration rate (GFR) and hospitalization unit (p < 0.01). Conclusions: Hyperglycemia during hospitalization affects more than half of hospitalized patients and is associated with a longer length of stay.

Estudio de las alteraciones del metabolismo hidrocarbonado en pacientes no diabéticos con nutrición enteral

“…Existe discrepancia en cuanto a los resultados de mortalidad hospitalaria de nuestro estudio con otros trabajos publicados en los que la mortalidad intrahospitalaria esta aumentada en el grupo de hiperglucemia de estrés (269,272,273) e incluso que se mantiene esta diferencia en el año siguiente del ingreso. Esta diferencia la atribuimos a que no se ha podido disponer de los datos de mortalidad intrahospitalaria de los centros de destino de los pacientes.…”

“…La situación de estrés del proceso agudo condiciona una peor evolución clínica del paciente, con estancias hospitalarias más prolongadas y con menor probabilidad de ser dado de alta (269,272). En nuestro caso, para poder valorar la influencia del proceso agudo se determinó en análisis bioquímico los niveles de PCR, de este modo niveles de PCR más elevadas fueron un factor independiente de estancia hospitalaria.…”