SESSION TITLE: Outcomes/Quality Control Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Elevated blood glucose is a common pathophysiological response to the stress of acute illness and is reported to be associated with poor outcomes. Limited literature exists on the impact of admission blood glucose levels on acute respiratory failure caused by acute exacerbation of COPD. Our objective was to determine the effect of admission blood glucose levels on duration of ventilatory support, ICU length of stay and hospital length of stay in patients admitted to the ICU with acute respiratory failure due to COPD exacerbation.
METHODS: Records of patients admitted to the ICU with acute respiratory failure due to acute exacerbation of COPD were reviewed. Patient demographics, admission blood glucose level (B.glucose), duration of ventilatory support, ICU length of stay (ICU LOS) and hospital length of stay (HospLOS) were noted. Number of patients with diabetes mellitus (DM); on chronic steroids; requiring invasive mechanical ventilation (MV), non-invasive MV (NIMV) or only Oxygen (O2) therapy was also recorded. Univariate regression analysis was performed to determine the effect of admission blood glucose on duration of ventilatory support, ICU LOS and HospLOS. p<0.05 was deemed statistically significant.
RESULTS: Of 75 patients studied, 46% were males. Average age was 72±11years. Mean B. glucose was 156±70 gm/dL; 20% had B.glucose>180mg/dL. DM was present in 49% and 16% were on chronic steroid therapy. Mean ICU LOS was 3.4±3days, HospLOS was 8.5±6days. Twenty-two percent patients received MV; 72% received NIMV and 6% were treated with only O2 therapy. Mean duration of ventilatory support was 3±3.3 days. Statistical analysis revealed that B.glucose significantly correlated with duration of ventilatory support (p< 0.0001), ICU LOS (p<0.0001) and HospLOS (p=0.0018). Mean duration of ventilatory support was 2.5±2 days in patients with B.glucose <180mg/dL and 4.8±5 days in patients with B.glucose >180mg/dL (p= 0.01).
CONCLUSIONS: Higher blood glucose at admission indicates a worse outcome in patients admitted to the ICU with Acute Respiratory Failure due to COPD Exacerbation. It is associated with a longer duration of ventilatory support, ICU LOS and HospLOS in these patients.
CLINICAL IMPLICATIONS: Further studies are needed to confirm the above findings in larger patient groups and to determine if better control of hyperglycemia in Acute Respiratory Failure due to COPD exacerbation improves outcome.
DISCLOSURE: The following authors have nothing to disclose: Danae Delivanis, Joshua Dill, N. Burki, R. ZuWallack, D. Datta
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