An Update on Inpatient Glycemic Control in U.S. Hospitals.
Endocr Pract. 2011 May 6;:1-22
Authors: Swanson CM, Potter DJ, Kongable GL, Cook CB
Objective: To provide data on glucose control in US hospitals, analyzing measurements from the largest number of facilities to date.Methods: Point-of-care bedside glucose (POC-BG) tests were extracted from 575 hospitals from January 2009 to December 2009 using a laboratory information management system. Glycemic control for patients in the intensive care unit (ICU) and non-ICU areas was assessed by calculating patient-day-weighted mean POC-BG values and rates of hypoglycemia and hyperglycemia. The relationship of POC-BG levels with hospital characteristics was determined.Results: A total of 49,191,313 POC-BG measurements (12,176,299 ICU; 37,015,014 non-ICU) were obtained from 3,484,795 patients (653,359 ICU; 2,831,436 non-ICU). The mean POC-BG was 167 mg/dL for ICU patients and 166 mg/dL for non- ICU patients. The prevalence of hyperglycemia (<180 mg/dL) was 32.2% in ICU patients and 32.0% in non-ICU patients. The prevalence of hypoglycemia (<70 mg/dL) was 6.3% in ICU patients and 5.7% in non-ICU patients. Patient-day-weighted mean POC-BG levels varied according to hospital size (P<.01), type (P<.01), and geographic location (P<.01) for ICU and non-ICU patients, with larger (?400 beds), academic, and Western hospitals having the lowest mean POC-BG. The percentage of patient days in the ICU characterized by hypoglycemia was highest among larger and academic hospitals (P<.05) and least among hospitals in the Northeast (P<.001).Conclusions: Hyperglycemia is common in US hospitals, and glycemic control may vary according to hospital characteristics. Increased hospital participation in data warehousing may support a national benchmarking process for the development of best practices to manage inpatient hyperglycemia.
PMID: 21550947 [PubMed - as supplied by publisher]