Abstract:
Background:Dysglycemiaswhich includes hypoglycemia, hyperglycemia and increased
glycemic variability has adverse clinical outcomes in critically ill patients. It is associated
with adverse events such as increased mortality, length ofhospital stay, length of ICU stay,
need of mechanical ventilation and also increased rates of surgical site infections.
Objectives: The objective of the study was to assess the magnitude of glycemic level and
its association with adverse events in patients more than 14 years admitted at AURH ICU.
Method: A hospital based retrospective cohort study was conducted using datafrom
medical record of patients at AURH Intensive Care Unit. A Study was conducted on 229 -
sample selected by simple random sampling technique on the medical record of patients
admitted over 3 year periodwhich fulfills the inclusion criteria. A validated checklist in the
English language was prepared. Data was checked manually, coded, and then analyzed by
SPSS statistical software.Bivariate and multivariable logistic regression analyses was
employed to identify adverse events associated with poor glycemic level. Adjusted odds
ratio along with 95% confidence interval was calculated to see the strength of association
and P-value of less than 0.05 was taken to judge level of significance.
Result: The prevalence ofhypoglycemia,hyperglycemia and increased glycemic variability
in the first 24 hour of admission was 5.2%, 29.3% and 38.3% respectively. The presence of
hypoglycemia in the first 24 hours of ICU admission was associated with increased
mortality, increased the incidence of shock by 93% and increases the need for mechanical
ventilation by 23%. Hyperglycemiaalsoincreased the risk of mortality by approximately
75%. The presence of increased glycemic variability was associated with worse outcomes,
including increased mortality, increased the incidence of shock and increase the need for
mechanical ventilation.
Conclusion: The prevalence of hyperglycemia in this study was lower than other studies.
On the other hand, hypoglycemia and increased glycemic variability were common. The
three glycemic levels were independently associated with increased mortality and
influenced other outcomes including, incidence of shock and need for mechanical
ventilation.
