Hyperglycemia
Conditions
Keywords
Diabetes, Nutrition/Dietics, clinical outcomes, total parenteral nutrition
Brief summary
A growing body of evidence suggests hyperglycemia is associated with adverse outcomes in patients with and without diabetes. Observational studies document an association between hyperglycemia and poor clinical outcomes in cardiothoracic surgery, elective surgery, myocardial infarction, stroke. Randomized studies indicate glycemic control is associated with improved outcomes in diabetic patients with critically illness. Hyperglycemia is a recognized and common complication of patients receiving total parenteral nutrition (TPN). Few studies in the literature have looked into the impact of TPN-associated inhospital complications and mortality. Accordingly, this study aims to evaluate the impact of hyperglycemia on clinical outcome (infections, systemic sepsis, cardiac complications, acute renal failure, length of stay, and mortality) in patients receiving TPN. We will perform a retrospective chart review of all patients treated with TPN from 1/01/06 to 12/31/06 at Grady Memorial Hospital. We hypothesize that patients receiving TPN who develop hyperglycemia experience higher morbidity (infections, systemic sepsis, cardiac complications, acute renal failure, length of stay) and mortality compared to TPN patients with euglycemia. The results of this study will help us to formulate a prospective randomized clinical trial on the management of TPN-associated hyperglycemia in hospitalized patients. This study aims to evaluate the impact of hyperglycemia on clinical outcome (infections, systemic sepsis, cardiac complications, acute renal failure, length of stay, in hospital mortality) in patients receiving total parenteral nutrition. We will perform a retrospective chart review of all patients admitted to the hospital receiving TPN from 1/01/06 to 12/31/06 at Grady Memorial Hospital. The results of this study will help us to formulate a prospective randomized clinical trial on the management of TPN-associated hyperglycemia in hospitalized patients.
Detailed description
Hypotheses: We hypothesize that patients receiving TPN who develop hyperglycemia experience higher morbidity (infections, systemic sepsis, cardiac complications, acute renal failure, length of stay) and mortality compared to TPN patients with euglycemia. Specific Aim: To determine the impact of hyperglycemia on clinical outcome (infection, systemic sepsis, cardiac complications, acute renal failure, length of stay, mortality) in patients receiving total parenteral nutrition.
Interventions
None listed
Sponsors
Emory University
Study design
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Perform a retrospective chart analysis of all patients receiving TPN at Grady Memorial Hospital during the period of 1/01/06 to 12/31/06.
Exclusion criteria
None except for charts without adequate data sufficient for chart review.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | at the end of the chart review of all patients | Mortality rate of those with hyperglycemia while on TPN duing the period of 1/01/06 to 12/31/06. |
Countries
United States
Participant flow
Recruitment details
170 charts reviewed
Pre-assignment details
Nothing to disclose.
Participants by arm
| Arm | Count |
|---|---|
| Those Exposed to TPN | 163 |
| Total | 163 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | lack of information in chart | 7 |
Baseline characteristics
| Characteristic | Those Exposed to TPN |
|---|---|
| Age, Categorical <=18 years | 4 Participants |
| Age, Categorical >=65 years | 39 Participants |
| Age, Categorical Between 18 and 65 years | 120 Participants |
| Age, Continuous | 60 years STANDARD_DEVIATION 17 |
| Region of Enrollment United States | 163 participants |
| Sex: Female, Male Female | 57 Participants |
| Sex: Female, Male Male | 106 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Primary
Mortality
Mortality rate of those with hyperglycemia while on TPN duing the period of 1/01/06 to 12/31/06.
Time frame: at the end of the chart review of all patients
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Those Exposed to TPN | Mortality | 36 mortality rate |