Literature DB >> 33794469

Hypoglycemic episodes predict length of stay in patients with acute burns.

Christopher H Pham1, Sebastian Q Vrouwe1, Karen Tsai2, Li Ding3, Zachary J Collier1, Andrea C Grote1, Trevor E Angell3, Warren L Garner1, T Justin Gillenwater1, Haig A Yenikomshian4.   

Abstract

Hypoglycemic episodes are associated with worse hospital outcomes. All adult patients admitted to our burn center from 2015 to 2019 were retrospectively reviewed. Patient demographics and burn characteristics were recorded. The primary outcome was mortality, and secondary outcomes were total length-of-stay and intensive care unit length-of-stay. All patients experiencing at least one hypoglycemic episode were compared to patients who did not experience hypoglycemia. There were 914 patients with acute burns admitted during the study period, 33 of which (4%) experienced hypoglycemic episodes. Of these, 17 patients (52%) experienced a single hypoglycemic episode, while the remainder experienced multiple hypoglycemic episodes. Patients with one or more hypoglycemic events were matched to non-hypoglycemic controls using propensity matching. Patients that experienced hypoglycemia had significantly less TBSA involvement (5% vs. 13%,median, p < 0.0002), higher prevalence of diabetes (48% vs. 18%, p < 0.0001), higher mortality (18% vs. 7%, p = 0.01), longer total length-of-stay (22 vs. 8 days, median, p < 0.0001), and longer ICU length-of-stay (12 vs. 0 days, median, p < 0.0001). A single hypoglycemic episode was associated with prolonged total (IRR = 1.91, p < 0.0001) and ICU length-of-stay (IRR = 3.86, p < 0.0001). Hypoglycemia was not associated with higher mortality in the survival analysis (p = 0.46).
Copyright © 2021 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Burns; Critical care; Endocrinology; Hypoglycemia; Insulin; Thermal injury

Mesh:

Substances:

Year:  2021        PMID: 33794469      PMCID: PMC8527897          DOI: 10.1016/j.jcrc.2021.03.005

Source DB:  PubMed          Journal:  J Crit Care        ISSN: 0883-9441            Impact factor:   4.298


  33 in total

1.  Hypoglycemia and outcome in critically ill patients.

Authors:  Moritoki Egi; Rinaldo Bellomo; Edward Stachowski; Craig J French; Graeme K Hart; Gopal Taori; Colin Hegarty; Michael Bailey
Journal:  Mayo Clin Proc       Date:  2010-02-22       Impact factor: 7.616

2.  Simplified estimates of the probability of death after burn injuries: extending and updating the baux score.

Authors:  Turner Osler; Laurent G Glance; David W Hosmer
Journal:  J Trauma       Date:  2010-03

3.  Flawed analytical method used for reference glucose.

Authors:  George Cembrowski
Journal:  Can J Anaesth       Date:  2019-07-09       Impact factor: 5.063

4.  Clinical impact of sample interference on intensive insulin therapy in severely burned patients: a pilot study.

Authors:  Nam K Tran; Zachary R Godwin; Jennifer C Bockhold; Anthony G Passerini; Julian Cheng; Morgan Ingemason
Journal:  J Burn Care Res       Date:  2014 Jan-Feb       Impact factor: 1.845

5.  Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: methods of reducing patient risk.

Authors:  Heather F Pidcoke; Charles E Wade; Elizabeth A Mann; Jose Salinas; Brian M Cohee; John B Holcomb; Steven E Wolf
Journal:  Crit Care Med       Date:  2010-02       Impact factor: 7.598

6.  Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients.

Authors:  Marc G Jeschke; Ruxandra Pinto; David N Herndon; Celeste C Finnerty; Robert Kraft
Journal:  Crit Care Med       Date:  2014-05       Impact factor: 7.598

7.  Benefits and risks of tight glucose control in critically ill adults: a meta-analysis.

Authors:  Renda Soylemez Wiener; Daniel C Wiener; Robin J Larson
Journal:  JAMA       Date:  2008-08-27       Impact factor: 56.272

8.  Safety and efficacy of an intensive insulin protocol in a burn-trauma intensive care unit.

Authors:  Amalia Cochran; Lynn Davis; Stephen E Morris; Jeffrey R Saffle
Journal:  J Burn Care Res       Date:  2008 Jan-Feb       Impact factor: 1.845

9.  Mild hypoglycemia is strongly associated with increased intensive care unit length of stay.

Authors:  James Krinsley; Marcus J Schultz; Peter E Spronk; Floris van Braam Houckgeest; Johannes P van der Sluijs; Christian Mélot; Jean-Charles Preiser
Journal:  Ann Intensive Care       Date:  2011-11-24       Impact factor: 6.925

Review 10.  Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.

Authors:  Simon Finfer; Jan Wernerman; Jean-Charles Preiser; Tony Cass; Thomas Desaive; Roman Hovorka; Jeffrey I Joseph; Mikhail Kosiborod; James Krinsley; Iain Mackenzie; Dieter Mesotten; Marcus J Schultz; Mitchell G Scott; Robbert Slingerland; Greet Van den Berghe; Tom Van Herpe
Journal:  Crit Care       Date:  2013-06-14       Impact factor: 9.097

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