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Retrospective Study of Glycemic Control Following Transition From the Intensive Care Unit in a National Sample of US Hospitals.
Endocr Pract. 2015 Jun 29;
Authors: Bersoux S, Cook CB, Kongable GL, Shu J
Abstract
OBJECTIVE: Retrospective study to evaluate glycemic control outcomes after transition from the intensive care unit (ICU) to a non-ICU area in a national sample of US hospitals.
METHODS: Mean point-of-care blood glucose (POC-BG) data were assessed overall and at 24 hours before and up to 72 hours after the transition. Comparisons in glucose variability (standard deviation of POC-BG data) were assessed. Impact on glycemic control was evaluated after accounting for hospital characteristics through logistic regression analysis.
RESULTS: POC-BG data were obtained from 576 hospitals. Mean (SD) POC-BG values in ICU vs non-ICU areas were 176 (24) vs 169 (21) mg/dL (P<.01). Mean (SD) of the ICU POC-BG data were 76 (16) vs 73 (16) mg/dL in the non-ICU data (P<.01). However, when comparing values of POC-BG in the last 24-hour ICU period with those from up to 72 hours posttransition, we found no differences, indicative of overall stable glycemic control and variability after transition. Deterioration of glucose control following the transition was significantly associated with hospital size (P<.01): The smallest hospitals had the highest percentage of these cases. In addition, geographic region showed significant variability (P=.04), with hospitals in Midwest and West having highest proportion of cases in which glycemic control worsened following the transition.
CONCLUSION: Glycemic control and variability did not change after transition from the ICU, but outcomes may depend on certain hospital characteristics. Inpatient glycemic control assessment should move beyond cross-sectional studies and consider the impact of transitioning across inpatient areas. Other statistical approaches to studying this question should be evaluated.
PMID: 26121449 [PubMed - as supplied by publisher]