Document Detail


Stress-induced hyperglycemia in patients with severe sepsis: a compromising factor for survival.
MedLine Citation:
PMID:  19092319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the clinical and laboratory characteristics of patients with severe sepsis and baseline hyperglycemia and investigate the impact of hyperglycemia on the final outcome. PATIENTS: A total of 265 patients admitted with severe sepsis in 3 major hospitals in South-Western Greece, during a 1-year period, were included in the study. Patients were divided in 3 groups according to their glycemic profile at admission: patients with stress hyperglycemia (group SH, n=47), with diabetes mellitus (group DM, n=65), and with normal glucose level (group NG, n=153). Hyperglycemia was defined as an admission or in-hospital fasting glucose level of >or=126 mg/dL or a random blood glucose level of >or=200 mg/dL on >or=2 determinations. RESULTS: A total of 42.2% of patients with severe sepsis had baseline hyperglycemia with 17.7% having sepsis-induced stress hyperglycemia. No family history was noted in the SH group. A higher percentage of septic patients with stress hyperglycemia died compared with patients with normal glucose levels (42.5% versus 13.7%) and diabetics (42.5% versus 24.6%). Group DM had also a poorer prognosis than group NG (24.6% versus 13.7%). A positive correlation was detected between the fasting blood glucose levels of group SH and the severity of sepsis indicated by sepsis-related organ failure assessment score. CONCLUSION: Baseline hyperglycemia, including stress-induced hyperglycemia, is common in patients with severe sepsis. Stress-induced hyperglycemia is related to a more severe disease and poorer prognosis.
Authors:
Leonidia Leonidou; Marina Michalaki; Ageliki Leonardou; Eftihia Polyzogopoulou; Kalliopi Fouka; Miltiadis Gerolymos; Pantelis Leonardos; Agathoklis Psirogiannis; Venetsana Kyriazopoulou; Charalambos A Gogos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  336     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  467-71     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Patras University Hospital, Rion-Patras, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Animals
Female
Humans
Hyperglycemia / physiopathology*
Male
Middle Aged
Prospective Studies
Sepsis / physiopathology*
Stress, Physiological*
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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