0
Education, Teaching, and Quality Improvement |

Blood Glucose Levels at Admission as a Prognostic Indicator in Patients With Acute Respiratory Failure Due to COPD Exacerbation

Danae Delivanis, MD; Joshua Dill, MD; N. Burki, MD; R. ZuWallack, MD; D. Datta, MD
Author and Funding Information

University of CT Health Center, Farmington, CT


Chest. 2013;144(4_MeetingAbstracts):550A. doi:10.1378/chest.1675781
Text Size: A A A
Published online

Abstract

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

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543